Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2020 Jul 9;21(1):448.
doi: 10.1186/s12891-020-03477-x.

No differences in cost-effectiveness and short-term functional outcomes between cemented and uncemented total knee arthroplasty

R Rassir  1 , P A Nolte  2 , J C T van der Lugt  3 , R G H H Nelissen  4 , I N Sierevelt  5 , W C Verra  4   6
Affiliations
Observational Study

No differences in cost-effectiveness and short-term functional outcomes between cemented and uncemented total knee arthroplasty

R Rassir et al. BMC Musculoskelet Disord. .

Abstract

Background: There is an ongoing debate regarding optimal fixation of total knee arthroplasty (TKA), however cost has not been addressed as profoundly. Therefore, the current study primarily aimed to compare costs and cost-effectiveness 1 year after cemented or uncemented TKA. A secondary objective was to compare short-term functional outcomes between both groups.

Methods: A posthoc prospective observational multicenter cohort study of 60 cemented and 50 uncemented Low Contact Stress (LCS) knee systems. Outcome was evaluated using the EuroQol5D-3 L (EQ5D) index, in order to calculate quality adjusted life years (QALYs). Total costs were calculated considering direct costs within the hospital setting (inpatient cost) as well as direct and indirect costs outside the hospital. Cost-effectiveness (total costs per QALY), Oxford Knee Score (OKS) and Numeric Rating Scale (NRS) were compared between cemented and uncemented cases at 1 year after surgery. HealthBASKET project, a micro-costing approach, represents the Dutch costs and situation and was used to calculate hospital stay. (In) direct costs outside the healthcare (medical cost and productivity cost) were determined using two validated questionnaires.

Results: Median costs per QALY were similar between cemented and uncemented TKA patients (€16,269 and €17,727 respectively; p = 0.50). Median OKS (44 and 42; p = 0.79), EQ5D (0.88 and 0.90; p = 0.82) and NRS for pain (1.0 and 1.0; p = 0.48) and satisfaction (9.0 and 9.0; p = 0.15) were also comparable between both groups.

Conclusion: For this type of knee implant (LCS), inpatient hospital costs and costs after hospitalization were comparable between groups.

Keywords: Cemented; Cost-effectiveness; Costs; Quality adjusted life years; Total knee Arthroplasty; Uncemented.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

References

    1. Singh JA. Epidemiology of knee and hip arthroplasty: a systematic review. Open Orthop J. 2011;5:80–85. doi: 10.2174/1874325001105010080. - DOI - PMC - PubMed
    1. Online LROI annual report 2019 . Stichting LROI. 2019.
    1. Drexler M, Dwyer T, Marmor M, Abolghasemian M, Sternheim A, Cameron HU. Cementless fixation in total knee arthroplasty: down the boulevard of broken dreams - opposes. J Bone Joint Surg (Br) 2012;94(11 Suppl a):85–89. doi: 10.1302/0301-620x.94b11.30827. - DOI - PubMed
    1. Yang JH, Yoon JR, Oh CH, Kim TS. Hybrid component fixation in total knee arthroplasty: minimum of 10-year follow-up study. J Arthroplast. 2012;27(6):1111–1118. doi: 10.1016/j.arth.2011.09.019. - DOI - PubMed
    1. Park JW, Kim YH. Simultaneous cemented and cementless total knee replacement in the same patients: a prospective comparison of long-term outcomes using an identical design of NexGen prosthesis. J Bone Joint Surg (Br) 2011;93(11):1479–1486. doi: 10.1302/0301-620x.93b11.27507. - DOI - PubMed

Publication types