IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0155524.html
   My bibliography  Save this article

Knee Joint Distraction Compared to Total Knee Arthroplasty for Treatment of End Stage Osteoarthritis: Simulating Long-Term Outcomes and Cost-Effectiveness

Author

Listed:
  • J A D van der Woude
  • S C Nair
  • R J H Custers
  • J M van Laar
  • N O Kuchuck
  • F P J G Lafeber
  • P M J Welsing

Abstract

Objective: In end-stage knee osteoarthritis the treatment of choice is total knee arthroplasty (TKA). An alternative treatment is knee joint distraction (KJD), suggested to postpone TKA. Several studies reported significant and prolonged clinical improvement of KJD. To make an appropriate decision regarding the position of this treatment, a cost-effectiveness and cost-utility analysis from healthcare perspective for different age and gender categories was performed. Methods: A treatment strategy starting with TKA and a strategy starting with KJD for patients of different age and gender was simulated. To extrapolate outcomes to long-term health and economic outcomes a Markov (Health state) model was used. The number of surgeries, QALYs, and treatment costs per strategy were calculated. Costs-effectiveness is expressed using the cost-effectiveness plane and cost-effectiveness acceptability curves. Results: Starting with KJD the number of knee replacing procedures could be reduced, most clearly in the younger age categories; especially revision surgery. This resulted in the KJD strategy being dominant (more effective with cost-savings) in about 80% of simulations (with only inferiority in about 1%) in these age categories when compared to TKA. At a willingness to pay of 20.000 Euro per QALY gained, the probability of starting with KJD to be cost-effective compared to starting with a TKA was already found to be over 75% for all age categories and over 90–95% for the younger age categories. Conclusion: A treatment strategy starting with knee joint distraction for knee osteoarthritis has a large potential for being a cost-effective intervention, especially for the relatively young patient.

Suggested Citation

  • J A D van der Woude & S C Nair & R J H Custers & J M van Laar & N O Kuchuck & F P J G Lafeber & P M J Welsing, 2016. "Knee Joint Distraction Compared to Total Knee Arthroplasty for Treatment of End Stage Osteoarthritis: Simulating Long-Term Outcomes and Cost-Effectiveness," PLOS ONE, Public Library of Science, vol. 11(5), pages 1-13, May.
  • Handle: RePEc:plo:pone00:0155524
    DOI: 10.1371/journal.pone.0155524
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0155524
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0155524&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0155524?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Hideki Higashi & Jan J Barendregt, 2011. "Cost-Effectiveness of Total Hip and Knee Replacements for the Australian Population with Osteoarthritis: Discrete-Event Simulation Model," PLOS ONE, Public Library of Science, vol. 6(9), pages 1-11, September.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Eren Demir & David Southern, 2017. "Enabling better management of patients: discrete event simulation combined with the STAR approach," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 68(5), pages 577-590, May.
    2. Argelio Santos & James Gurling & Marcel F Dvorak & Vanessa K Noonan & Michael G Fehlings & Anthony S Burns & Rachel Lewis & Lesley Soril & Nader Fallah & John T Street & Lise Bélanger & Andrea Townson, 2013. "Modeling the Patient Journey from Injury to Community Reintegration for Persons with Acute Traumatic Spinal Cord Injury in a Canadian Centre," PLOS ONE, Public Library of Science, vol. 8(8), pages 1-10, August.
    3. Ruth Pulikottil-Jacob & Martin Connock & Ngianga-Bakwin Kandala & Hema Mistry & Amy Grove & Karoline Freeman & Matthew Costa & Paul Sutcliffe & Aileen Clarke, 2016. "Has Metal-On-Metal Resurfacing Been a Cost-Effective Intervention for Health Care Providers?—A Registry Based Study," PLOS ONE, Public Library of Science, vol. 11(11), pages 1-13, November.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0155524. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.