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Study: Spine surgery is as cost-effective as total hip or knee arthroplasty for primary osteoarthritis
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Researchers found similar 5-year lifetime incremental cost-utility ratios for spinal surgical management and total hip or knee arthroplasty in patients with primary osteoarthritis of the spine, hip or knee.
“Despite a significantly higher revision rate, the overall surgical management of focal lumbar spinal stenosis for those who have failed medical management results in similar median 5-year and lifetime cost-utility compared with those of total hip arthroplasty and total knee arthroplasty for the treatment of osteoarthritis from the limited perspective of a public health insurance system,” the authors wrote in the abstract.
The researchers collected long-term health status data prospectively for surgical outcomes and retrospectively for costs on patients who underwent primary one- to two-level decompression with or without fusion or total hip (THA) or total knee arthroplasty (TKA) for primary osteoarthritis at an average of 5 years follow-up.
Five-year incremental cost-utility ratios (ICURs) were $21,702 per quality adjusted life year (QALY) for THA, $28,595 per QALY for TKA, $12,271 per QALY for spinal decompression without fusion and $35,897 per QALY for spinal decompression with fusion. The lifetime ICURs were $5,682 per QALY for THA, $6,489 per QALY for TKA, $2,994 per QALY for spinal decompression without fusion and $10,806 per QALY for spinal decompression with fusion. Overall, the ICUR for spinal surgery was $5,617 per QALY.
“Surgical management of primary osteoarthritis of the spine, hip and knee results in durable cost-utility ratios that are well below accepted thresholds for cost effectiveness,” the authors wrote.
Disclosure: Rampersaud is a consultant for Medtronic.
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