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Can Robot-Assisted Unicompartmental Knee Arthroplasty Be Cost-Effective? A Markov Decision Analysis
- Source :
- The Journal of Arthroplasty. 31:759-765
- Publication Year :
- 2016
- Publisher :
- Elsevier BV, 2016.
-
Abstract
- 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. Methods We created a Markov decision analysis to evaluate the costs, outcomes, and incremental cost-effectiveness of robot-assisted UKA in 64-year-old patients with end-stage unicompartmental knee osteoarthritis. Results Robot-assisted UKA was more costly than traditional UKA, but offered a slightly better outcome with 0.06 additional quality-adjusted life-years at an incremental cost of $47,180 per quality-adjusted life-years, given a case volume of 100 cases annually. The system was cost-effective when case volume exceeded 94 cases per year, 2-year failure rates were below 1.2%, and total system costs were Conclusion Robot-assisted UKA is cost-effective compared with traditional UKA when annual case volume exceeds 94 cases per year. It is not cost-effective at low-volume or medium-volume arthroplasty centers.
- Subjects :
- Reoperation
musculoskeletal diseases
medicine.medical_specialty
Knee Joint
Cost effectiveness
Cost-Benefit Analysis
medicine.medical_treatment
Decision Support Techniques
03 medical and health sciences
0302 clinical medicine
medicine
Humans
Orthopedics and Sports Medicine
030212 general & internal medicine
Arthroplasty, Replacement, Knee
Unicompartmental knee arthroplasty
Survival rate
health care economics and organizations
Aged
030222 orthopedics
Cost–benefit analysis
business.industry
Decision Trees
Robotics
Middle Aged
Osteoarthritis, Knee
Arthroplasty
Hospitals
Markov Chains
Quality-adjusted life year
Survival Rate
Physical therapy
Quality-Adjusted Life Years
business
Decision analysis
Subjects
Details
- ISSN :
- 08835403
- Volume :
- 31
- Database :
- OpenAIRE
- Journal :
- The Journal of Arthroplasty
- Accession number :
- edsair.doi.dedup.....15df21728a2bb21738d6a1efaee0cdec