AI Article Synopsis
- A study examined the costs associated with nonoperative treatments for knee osteoarthritis (OA) in patients leading up to total knee arthroplasty (TKA), focusing on data from January 2018 to December 2019.
- It found that the average cost of these nonoperative procedures was $1,355 per patient, with intra-articular corticosteroid injections being the most common treatment and hyaluronic acid injections being the most expensive.
- The research revealed that costs varied significantly by gender and geography, highlighting discrepancies that underscore the need for further studies on the effectiveness of these treatments.
Article Abstract
Background: The convergence of national priorities to reduce health-care costs and deliver high-value care warrants the need to examine health-care utilization. The objective of this study was to describe the costs associated with nonoperative procedures in the 1-year period leading up to primary total knee arthroplasty (TKA).
Methods: An observational cohort study was conducted using the IBM Watson Health MarketScan databases. Patients with late-stage knee osteoarthritis (OA) who underwent unilateral, isolated primary TKA from January 1, 2018, to December 31, 2019, were included. The main outcome was the cost of knee OA-related payments for identified nonoperative procedures in the 1-year period before surgery. Nonoperative procedures examined were (1) physical therapy (PT); (2) bracing; (3) intra-articular injections: professional fee, hyaluronic acid (IA-HA), and corticosteroids (IA-CS); (4) medication: nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and acetaminophen; and (5) knee-specific imaging.
Results: The study population included 24,492 TKA patients with a mean age of 60.4 ± 8.0 years. The average total cost of nonoperative procedures per patient was $1,355 ± $2,087. The most common nonoperative treatment prescribed was IA-CS (54.3%). The nonoperative procedure with the highest cost per patient was IA-HA ($1,019 ± $913 per patient). The total cost of nonoperative procedures was higher among female compared with male patients ($1,440 ± $2,159 versus $1,254 ± $1,992 per patient; p < 0.01). The highest costs were found for patients in the Northeast ($1,740 ± $2,437 per patient). A total of 14,346 (58.6%) and 7,831 (32.0%) of the patients had >1 and ≥3 nonoperative treatments, respectively.
Conclusions: There is substantial variation in the type and the cost of nonoperative treatment for patients with late-stage OA. Future studies should investigate the effectiveness of nonoperative treatments at different stages of the disease.
Level Of Evidence: Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.
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| http://dx.doi.org/10.2106/JBJS.21.01415 | DOI Listing |
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