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Percutaneous Kirschner Wire Versus Commercial Implant for Hammertoe Repair: A Cost-Effectiveness Analysis.
- Source :
-
The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons [J Foot Ankle Surg] 2018 Mar - Apr; Vol. 57 (2), pp. 332-338. - Publication Year :
- 2018
-
Abstract
- Hammertoe deformities are one of the most common foot deformities, affecting up to one third of the general population. Fusion of the joint can be achieved with various devices, with the current focus on percutaneous Kirschner (K)-wire fixation or commercial intramedullary implant devices. The purpose of the present study was to determine whether surgical intervention with percutaneous K-wire fixation versus commercial intramedullary implant is more cost effective for proximal interphalangeal joint arthrodesis in hammertoe surgery. A formal cost-effectiveness analysis using a decision analytic tree model was conducted to investigate the healthcare costs and outcomes associated with either K-wire or commercial intramedullary implant fixation. The outcomes assessed included long-term costs, quality-adjusted life-years (QALYs), and incremental cost per QALY gained. Costs were evaluated from the healthcare system perspective and are expressed in U.S. dollars at a 2017 price base. Our results found that commercial implants were minimally more effective than K-wires but carried significantly higher costs. The total cost for treatment with percutaneous K-wire fixation was $5041 with an effectiveness of 0.82 QALY compared with a commercial implant cost of $6059 with an effectiveness of 0.83 QALY. The incremental cost-effectiveness ratio of commercial implants was $146,667. With an incremental cost-effectiveness ratio of >$50,000, commercial implants failed to justify their proposed benefits to outweigh their cost compared to percutaneous K-wire fixation. In conclusion, percutaneous K-wire fixation would be preferred for arthrodesis of the proximal interphalangeal joint for hammertoes from a healthcare system perspective.<br /> (Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Arthrodesis methods
Bone Wires statistics & numerical data
Cohort Studies
Cost Savings
Decision Trees
Hammer Toe Syndrome diagnosis
Health Care Costs
Humans
Prostheses and Implants statistics & numerical data
Quality-Adjusted Life Years
Treatment Outcome
United States
Arthrodesis economics
Arthrodesis instrumentation
Bone Wires economics
Cost-Benefit Analysis
Hammer Toe Syndrome surgery
Prostheses and Implants economics
Subjects
Details
- Language :
- English
- ISSN :
- 1542-2224
- Volume :
- 57
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons
- Publication Type :
- Academic Journal
- Accession number :
- 29478480
- Full Text :
- https://doi.org/10.1053/j.jfas.2017.10.019