ArticleCanadian journal of surgery. Journal canadien de chirurgie2012
Comparison of lifetime incremental cost:utility ratios of surgery relative to failed medical management for the treatment of hip, knee and spine osteoarthritis modelled using 2-year postsurgical values.
Article in Canadian journal of surgery. Journal canadien de chirurgie, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Costs and models used in the economic analysis of Total Knee Replacement (TKR): A systematic review.PloS one · 2023Pooled it
- External fixation versus amputation in the treatment of ulcerated diabetic foot: a cost-utility analysis using real-world data and a discrete-event simulation model.Cost effectiveness and resource allocation : C/E · 2026Article
- Out-of-hours emergent surgery for degenerative spinal disease in Canada: a retrospective cohort study from a national registry.Lancet regional health. Americas · 2024Article
- Cost comparison between spinal versus general anesthesia for hip and knee arthroplasty: an incremental cost study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2022Article
- A Prospective Study of Lumbar Facet Arthroplasty in the Treatment of Degenerative Spondylolisthesis and Stenosis: Early Cost-effective Assessment from the Total Posterior Spine System (TOPS™) IDE Study.Journal of health economics and outcomes research · 2022Article
- Lifetime incremental cost-utility ratios for minimally invasive surgery for degenerative lumbar spondylolisthesis relative to failed medical management compared with total hip and knee arthroplasty for osteoarthritis.Canadian journal of surgery. Journal canadien de chirurgie · 2021Observational
- EQ-5D-5L utilities per health states in Spanish population with knee or hip osteoarthritis.Health and quality of life outcomes · 2019Observational
- A 1-Year Cost Analysis of Spinal Surgical Procedures in Spain: Neurosurgeons Versus Orthopedic Surgeons.Neurospine · 2019Article
- EUROSPINE 2017 FULL PAPER AWARD: Time to remove our rose-tinted spectacles: a candid appraisal of the relative success of surgery in over 4500 patients with degenerative disorders of the lumbar spine, hip or knee.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2018Article
- Article
- The cost-effectiveness of surgical treatment of medial unicompartmental knee osteoarthritis in younger patients: a computer model-based evaluation.The Journal of bone and joint surgery. American volume · 2015Article
- Transforaminal lumbar interbody fusion and posterior lumbar interbody fusion utilizing BMP-2 in treatment of degenerative spondylolisthesis: neither safe nor cost effective.Surgical neurology international · 2013Article
- Assessing the value of a total joint replacement.Current reviews in musculoskeletal medicine · 2012Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDemand for surgery to treat osteoarthritis (OA) of the hip, knee and spine has risen dramatically. Whereas total hip (THA) and total knee arthroplasty (TKA) have been widely accepted as cost-effective, spine surgeries (decompression, decompression with fusion) to treat degenerative conditions remain underfunded compared with other surgeries.
methodsAn incremental cost-utility analysis comparing decompression and decompression with fusion to THA and TKA, from the perspective of the provincial health insurance system, was based on an observational matched-cohort study of prospectively collected outcomes and retrospectively collected costs. Patient outcomes were measured using short-form (SF)-36 surveys over a 2-year follow-up period. Utility was modelled over the lifetime, and quality-adjusted life years (QALYs) were determined. We calculated the incremental cost per QALY gained by estimating mean incremental lifetime costs and QALYs of surgery compared with medical management of each diagnosis group after discounting costs and QALYs at 3%. Sensitivity analyses were also conducted.
resultsThe lifetime incremental cost:utility ratios (ICURs) discounted at 3% were $5321 per QALY for THA, $11,275 per QALY for TKA, $2307 per QALY for spinal decompression and $7153 per QALY for spinal decompression with fusion. The sensitivity analyses did not alter the ranking of the lifetime ICURs.
conclusionIn appropriately selected patients with leg-dominant symptoms secondary to focal lumbar spinal stenosis who have failed medical management, the lifetime ICUR for surgical treatment of.
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