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Comparative Study
. 2014 Jul 15:9:59.
doi: 10.1186/s13018-014-0059-6.

Costs of staged versus simultaneous bilateral total knee arthroplasty: a population-based study of the Taiwanese National Health Insurance Database

Aaron Chih-Chang Lin, En Chao, Che-Ming Yang, Hsyien-Chia Wen, Hsiao-Li Ma, Tzu-Chuan Lu
Comparative Study

Costs of staged versus simultaneous bilateral total knee arthroplasty: a population-based study of the Taiwanese National Health Insurance Database

Aaron Chih-Chang Lin et al. J Orthop Surg Res. .

Abstract

Background: Bilateral total knee arthroplasty (TKA) is required for many patients. There are few studies comparing the overall costs of staged and simultaneous bilateral TKA.

Methods: The Taiwan National Health Insurance Research Database (NHIRD) was searched, and the total medical costs of 452 patients who received simultaneous bilateral TKAs were compared with those of 690 who received staged bilateral TKAs.

Results: All categories of medical costs were lower in the simultaneous TKA group, with the exception of therapeutic procedure fees which were higher in the simultaneous bilateral TKA group. The 10-year prosthesis survival rates for simultaneous and staged bilateral TKA were 90.9% and 87.5% (p > 0.05), respectively.

Conclusions: These results indicate that simultaneous bilateral TKA is more cost effective than staged bilateral TKA. Prosthesis survival is not affected by the choice for staged or simultaneous bilateral TKA.

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Figures

Figure 1
Figure 1
The flowchart of data collection.
Figure 2
Figure 2
Comparison of medical expenses during hospitalization between simultaneous and staged bilateral TKA. According to different payment items, medical expenses during hospitalization between the two TKA groups (sum of the twice operations) were compared. (A) Diagnosis fees. (B) Ward fees. (C) Laboratory fees. (D) X-ray fees. (E) Surgical fees. (F) Rehabilitation fees. (G) Anesthesia fees. (H) Special materials fees. (I) Therapeutic procedure fees. (J) Drug fees. (K) Total medical expense. All p < 0.05.
Figure 3
Figure 3
Comparison of medical expenses during orthopedic outpatient visits over the first year postoperative period. Medical expenses during orthopedic outpatient visits over the first year postoperative period between the two TKA groups were compared. The horizontal reference lines indicated the averages of medical amounts over 1-year duration pre-operation.
Figure 4
Figure 4
Kaplan-Meier curve of the prosthesis survival of the simultaneous and staged bilateral TKA groups. Log-rank test, p = 0.062.
See this image and copyright information in PMC

Comment in

References

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