Improving Estimates of Annual Survival Rates for Medial Unicompartmental Knee Arthroplasty, a Meta-Analysis.

Background: Medial unicompartmental knee arthroplasty (mUKA) is an increasingly popular treatment option for medial compartment knee osteoarthritis. Published mUKA survival rates have varied. The purpose of this meta-analysis was to provide pooled estimates of mUKA survival 5 and 10 years postoperatively.

Quality-Adjusted Life Years After Hip and Knee Arthroplasty: Health-Related Quality of Life After 12,782 Joint Replacements.

Background: The quality-adjusted life year (QALY) is the preferred outcome measurement for cost-effectiveness analysis in health care. QALYs measure patient health-related quality of life with use of a value between 0 and 1. Few studies have provided original data delineating QALYs after hip and knee arthroplasty.

The Effect of Prior Hip Arthroscopy on Patient-Reported Outcomes After Total Hip Arthroplasty: An Institutional Registry-Based, Matched Cohort Study.

Background: A significant number of patients who undergo hip arthroscopy will subsequently undergo total hip arthroplasty (THA) or hip resurfacing arthroplasty (HRA), although limited evidence exists regarding effects of prior hip arthroscopy on the outcomes of these procedures.

Methods: Of 5091 patients who underwent hip arthroscopy, we identified 69 patients who underwent subsequent THA (46) or HRA (23). Patients were matched to patients with no history of hip arthroscopy.

What is the Long-term Economic Societal Effect of Periprosthetic Infections After THA? A Markov Analysis.

Background: Current estimates for the direct costs of a single episode of care for periprosthetic joint infection (PJI) after THA are approximately USD 100,000. These estimates do not account for the costs of failed treatments and do not include indirect costs such as lost wages.

Questions/purposes: The goal of this study was to estimate the long-term economic effect to society (direct and indirect costs) of a PJI after THA treated with contemporary standards of care in a hypothetical patient of working age (three scenarios, age 55, 60, and 65 years).

Long Term Societal Costs of Anterior Discectomy and Fusion (ACDF) versus Cervical Disc Arthroplasty (CDA) for Treatment of Cervical Radiculopathy.

Background: Current literature suggests that anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) have comparable clinical outcomes for the treatment of cervical radiculopathy. Given similar outcomes, an understanding of differences in long-term societal costs can help guide resource utilization. The purpose of this study was to compare the relative long-term societal costs of anterior cervical discectomy and fusion (ACDF) to cervical disc arthroplasty (CDA) for the treatment of single level cervical disc disease by considering upfront surgical costs, lost productivity, and risk of subsequent revision surgery.

Can Robot-Assisted Unicompartmental Knee Arthroplasty Be Cost-Effective? A Markov Decision Analysis.

Background: Unicompartmental knee arthroplasty (UKA) is a treatment option for single-compartment knee osteoarthritis. Robotic assistance may improve survival rates of UKA, but the cost-effectiveness of robot-assisted UKA is unknown. The purpose of this study was to delineate the revision rate, hospital volume, and robotic system costs for which this technology would be cost-effective.

Risk assessment tools used to predict outcomes of total hip and total knee arthroplasty.

This article reviews recently proposed clinical tools for predicting risks and outcomes in total hip arthroplasty and total knee arthroplasty patients. Additionally, we share the Massachusetts General Hospital experience with using the Risk Assessment and Prediction Tool to predict the need for an extended care facility after total joint arthroplasty.

The cost-effectiveness of surgical treatment of medial unicompartmental knee osteoarthritis in younger patients: a computer model-based evaluation.

Background: Surgical options for the management of medial compartment osteoarthritis of the varus knee include high tibial osteotomy, unicompartmental knee arthroplasty, and total knee arthroplasty. We sought to determine the cost-effectiveness of high tibial osteotomy and unicompartmental knee arthroplasty as alternatives to total knee arthroplasty for patients fifty to sixty years of age.

Methods: We built a probabilistic state-transition computer model with health states defined by pain, postoperative complications, and subsequent surgical procedures.

Complications of total elbow arthroplasty.

Modifications in implant design and improvements in surgical technique have expanded the applications of total elbow arthroplasty. Complications associated with reconstructive elbow surgery persist, however, often leading to profound and sometimes nonsalvageable disability. The most recognized complications include implant loosening, periprosthetic fracture, implant failure, infection, triceps insufficiency, and nerve palsy.