Study quantifies significant financial benefit of TKR for end-stage knee OA

All the total knee replacements performed in 2009 in the United States saved an estimated $12 billion in lifetime societal savings with most of that benefitting patients and employers, the researchers who conducted this study concluded.

“We know that when a knee replacement is done on patients at the appropriate time, it adds tremendous value to their lives. It gets them back to work and back to their families. It improves their quality of life and allows them to be productive and active again,” John R. Tongue, MD, American Academy of Orthopaedic Surgeons (AAOS) past-president, stated in an AAOS press release. “But until now, that value has been hard to quantify. This study allows patients to see the big picture of the effect on their daily lives and in the long term.”

John R. Tongue

Tongue and colleagues used a Markov model to estimate the direct and indirect cost savings for the more than 600,000 total knee replacements (TKR) for end-stage knee osteoarthritis (OA) during 2009 in the United States. They measured direct costs, which included expenditures for surgical and nonsurgical end-stage knee OA treatment, as well as indirect costs, including lost wages, lower earnings and disability payments, according to the abstract.

The investigators found a lifetime overall net benefit for TKR of $18,930 per patient. To determine this, they subtracted the mean increase in indirect lifetime savings of $20,635 that they found from the $39,565 societal savings associated with reduced indirect costs from TKR that they calculated.

Eighty-five percent of the savings accrued were from “increased employment and earnings,” and the other 15% in savings was from a reduced number of disability payments and fewer missed days of work, Tongue and colleagues concluded.

“With the new model we created for this study, we have opened the door to evaluate societal benefit for other types of health care services as well, which is truly exciting,” Lane Koenig, PhD, a study author and health care economist, from Rockville, Md., stated in the release. “The benefit of successful treatment of bone and joint conditions in the long term is known by the patients who’ve been through it, but these data offer evidence on the societal effects that will add to the conversation people are having about improved, cost-conscious health care.”

Reference:

Ruiz D. J Bone Joint Surg Am. 2013;doi:10.2106/JBJS.L.01488.

Disclosure: The authors report various financial disclosures. See the full study for a complete list of disclosures.