Introduction: Intra-articular joint injections have been used with the goal of providing patients with symptomatic relief. Recently, however, the efficacy of corticosteroid (CS) and hyaluronic acid (HA) injections in the management of knee osteoarthritis (OA) is questionable. In this analysis, we investigated the costs associated with injections by assessing overall use, conversion and average time to total knee arthroplasty (TKA), and reimbursement.
Methods: Patients aged 50 to 70 years with a knee-related diagnosis of pain, effusion, or OA were identified in the Humana insurance national data set. Patients who received intra-articular injections were stratified by the type and number of injection(s) received. The subsequent rates of TKA were compared with Kaplan-Meier curves for patients who underwent CS injections, HA injections, and a benchmarking cohort of patients with OA and no history of knee injections in the medical record. Average time to TKA was determined from index diagnosis, and total cost was compared using Wilcoxon rank sum analyses.
Results: A total of 778,686 patients were identified. Of these, 637,112 had no knee injection history, while 124,129 received CS and 17,445 received HA injections. The 10-year conversion to TKA was highest in HA cohort (31.6%), followed by the CS cohort (24.0%) and the noninjection cohort (7.3%) (P < 0.001). Time to TKA increased with number of injections for both injection types. For patients who underwent TKA, median cost was greater in HA ($16,687) and CS ($15,563) cohorts relative to noninjection cohort ($14,733) (P < 0.001).
Discussion: Compared with the noninjection cohort, both HA and CS cohorts experienced increased costs and increased time to TKA. However, while the cost incurred in HA cohort was greater than that in CS cohort, no appreciable benefit was demonstrated for conversion or time to TKA. Therefore, if intra-articular knee injections are indicated for the nonsurgical management of knee OA, the results of this study support CS over HA.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10566983 | PMC |
| http://dx.doi.org/10.5435/JAAOSGlobal-D-21-00203 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Purpose: Studies demonstrate similar long-term Total Knee Arthroplasty (TKA) outcomes in patients with significant versus minimal preoperative coronal plane deformity. Limited short-term outcomes data, which determine costs of care, exist.
Methods: We retrospectively explored the impact of preoperative coronal plane deformity on operative time, length of stay (LOS), and discharge to skilled nursing facility (SNF) in TKA.
Differentiating multiple sclerosis with predominant spinal cord and optic nerve involvement from other autoimmune demyelinating diseases using B cell immunophenotyping and gene expression profiling.
Mult Scler Relat Disord
December 2024
Istanbul University, Aziz Sancar Institute for Experimental Medical Research, Department of Neuroscience, Istanbul, Turkiye.
Objective: Multiple sclerosis (MS) may present with predominant involvement of the spinal cord and optic nerve (MS/w-SCON) and mimic other autoimmune inflammatory demyelinating disorders (AIDD) such as neuromyelitis optica spectrum disorder (NMOSD), and relapsing inflammatory optic neuritis (RION). Thus, biomarkers are required for effective differential diagnosis of AIDD.
Methods: Patients with MS/w-SCON (n = 20), MS without involvement of SCON (MS/wo-SCON) (n = 22), NMOSD (n = 16), RION (n = 15) and healthy individuals (n = 21) were included.
Association Between Anterior Knee Pain and Soft Tissue Gliding of the Anterior Knee Region After Total Knee Arthroplasty: A Cross-sectional Study.
Arch Phys Med Rehabil
December 2024
Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan; Department of Physiotherapy, Morinomiya University of Medical Sciences, Osaka, Japan; Inclusive Medical Sciences Research Institute, Morinomiya University of Medical Sciences, Osaka, Japan; AR-Ex Medical Research Center, Tokyo, Japan. Electronic address:
Objective: To investigate the relationship between impaired gliding in the anterior knee region and anterior knee pain (AKP) in patients after total knee arthroplasty (TKA).
Design: Cross-sectional study.
Setting: Orthopedic hospital PARTICIPANTS: Patients aged >60 years who underwent TKA between June and September 2023 without abnormal components or postoperative infections.
Can Lymphatic Transport Impaired by Total Knee Arthroplasty be Managed with Manual Lymphatic Drainage?
Lymphat Res Biol
December 2024
Meram Faculty of Medicine, Department of Orthopaedics and Traumatology, Necmettin Erbakan University, Konya, Turkey.
It is known that particles released from the prosthesis due to wear after joint replacement surgery affect the lymphatic system. This study aimed to investigate the effect of the manual lymphatic drainage (MLD) technique on pain, edema, and blood lactate dehydrogenase (LDH) levels in the early period of lymphatic transport affected by total knee arthroplasty (TKA). Twenty-four patients who underwent TKA were randomly allocated (control: 12; MLD: 12).
View Article and Find Full Text PDFEffect of posterior-stabilized and cruciate-retaining implants on three-dimensional kinematic characteristics after total knee arthroplasty.
Jt Dis Relat Surg
January 2025
Department of Joint Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
Objectives: This study aimed to analyze the effects of posteriorstabilized (PS) and cruciate-retaining (CR) total knee arthroplasty (TKA) on early postoperative three-dimensional (3D) dynamic and kinematic characteristics in patients with unilateral knee osteoarthritis (OA).
Patients And Methods: A retrospective analysis of prospectively collected data from 90 patients with unilateral TKA between February 2021 and September 2021 was conducted using a 3D kinematic analysis system before and six months after TKA. This patient group included 57 patients (10 males, 47 females; mean age: 69.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!