Unicompartmental Knee Arthroplasty a Cost-Effective Alternative to TKA

Unicompartmental knee arthroplasty was an economically appealing alternative to total knee arthroplasty for elderly patients, and potentially is cost-effective for younger patients as well, according to recently published study data.

New York City researchers compared unicompartamental knee arthroplasty (UKA) with total knee arthroplasty (TKA) in terms of lifetime costs, quality-adjusted life-years (QALYs) and incremental cost- effectiveness ratios (ICERs) using a Markov decision analytic model for patients who underwent one of the two procedures at 45, 55, 65, 75 or 85 years of age.

The researchers estimated transition probabilities using patients’ WOMAC scores, implant failure and need for revision using the Swedish Knee Arthroplastic Register, and costs using the Healthcare Cost and Utilization Project database.

According to the researchers’ findings, patients 65 years and older who undergo UKA in 2015 and 2020 are estimated to have a total lifetime societal savings of between $56 million to $336 million and $84 million to $554 million, respectively.

Overall, UKA was found to have lower lifetime costs and QALYs for patients 65 years and older than TKA, according to the researchers. Additionally, among patients 45 years old and 55 years old, TKA was shown to have ICERs of $30,300/QALY and $63,000/QALY, respectively.

UKA became cost-effective for 45-year-old and 55-year-old patients when the 20-year revision rate dropped from 27.8 percent to 25.7 percent and 27.9 percent to 26.7 percent, respectively, and can be a favorable choice if there are incremental improvements in implant survivorship, according to the data.