ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2017
Medial compartment knee osteoarthritis: age-stratified cost-effectiveness of total knee arthroplasty, unicompartmental knee arthroplasty, and high tibial osteotomy.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04574570 (Clinical Evaluations of the TOKA Customized Device for High Tibial Osteotomy in the Treatment of Knee Osteoarthritis), which is not on this map. Cited by 35 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Clinical Evaluations of the TOKA Customized Device for High Tibial Osteotomy in the Treatment of Knee Osteoarthritis: a Pilot Study.
Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it, 71 citations in OpenAlex.
- Unicompartmental knee arthroplasty is associated with lower pain levels but inferior range of motion, compared with high tibial osteotomy: a systematic overview of meta-analyses.Journal of orthopaedic surgery and research · 2022Pooled it
- Progress in the treatment of knee osteoarthritis with high tibial osteotomy: a systematic review.Systematic reviews · 2021Pooled it
- 3D-Printed Patient-Specific Instrumentation Technique Vs. Conventional Technique in Medial Open Wedge High Tibial Osteotomy: A Prospective Comparative Study.BioMed research international · 2020Trial
- Physical activity after unicompartmental knee arthroplasty: Long-term participation, activity volume and patient-reported limitations.Journal of experimental orthopaedics · 2026Article
- Beyond the Surgical Bill: Pharmacoeconomics and Real-World Utilization Across the Knee Osteoarthritis Care Pathway-A Critical Narrative Review.Healthcare (Basel, Switzerland) · 2026Review
- Functional and Clinical Outcomes after Medial Unicompartmental Knee Arthroplasty Compared with High Tibial Osteotomy in Isolated Medial Compartment Osteoarthritis.Journal of orthopaedic case reports · 2026Article
- Robot-assisted versus conventional unicompartmental knee arthroplasty: a retrospective comparative study of postoperative complications.BMC musculoskeletal disorders · 2026Article
- Evolving Strategies for Knee Osteoarthritis: A Narrative Review of Integrated Rehabilitation, Pharmacologic, and Joint-Preserving Interventions.Medical science monitor : international medical journal of experimental and clinical research · 2026Review
- Comparative efficacy of total knee arthroplasty versus unicompartmental knee arthroplasty in obese patients with medial knee osteoarthritis.Frontiers in medicine · 2026Article
- Article
- Opening wedge high tibial osteotomy using patient-specific instruments and custom-made plates results in accurate correction and improved clinical outcome measures at 1-year follow-up.Journal of experimental orthopaedics · 2025Article
- Decision Analysis in the Management of Hip and Knee Osteoarthritis: A Systematic Review.Cureus · 2025Review
- Learning curves for high tibial osteotomy using patient-specific instrumentation: a case control study.Innovative surgical sciences · 2024Article
- Comparison of short-term clinical outcomes between open-wedge high tibial osteotomy and tibial condylar valgus osteotomy.BMC musculoskeletal disorders · 2024Article
- Economic evaluation of acupuncture as an adjunctive treatment with usual care for mild-to-moderate knee osteoarthritis: A Markov model-based analysis.Integrative medicine research · 2023Article
- Unicompartmental Knee Arthroplasty Provides Superior Clinical and Radiological Outcomes Compared to High Tibial Osteotomy at a Follow-Up of 5-8 Years.Journal of clinical medicine · 2023Article
- Long-Term Survival and Predictors of Failure of Opening Wedge High Tibial Osteotomy.Orthopaedic surgery · 2023Article
- High Tibial Osteotomy Versus Unicompartmental Knee Arthroplasty for Unicompartmental Knee Osteoarthritis: A Systematic Review and Meta-Analysis.Indian journal of orthopaedics · 2022Article
- St Georg Sled medial unicompartmental arthroplasty: survivorship analysis and function at 20 years follow up.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Article
- A comparative study of 21,194 UKAs and 49,270 HTOs for the risk of unanticipated events in mid-age patients from the national claims data in South Korea.BMC musculoskeletal disorders · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo compare the age-based cost-effectiveness of total knee arthroplasty (TKA), unicompartmental knee arthroplasty (UKA), and high tibial osteotomy (HTO) for the treatment of medial compartment knee osteoarthritis (MCOA).
methodsA Markov model was used to simulate theoretical cohorts of patients 40, 50, 60, and 70 years of age undergoing primary TKA, UKA, or HTO. Costs and outcomes associated with initial and subsequent interventions were estimated by following these virtual cohorts over a 10-year period. Revision and mortality rates, costs, and functional outcome data were estimated from a systematic review of the literature. Probabilistic analysis was conducted to accommodate these parameters' inherent uncertainty, and both discrete and probabilistic sensitivity analyses were utilized to assess the robustness of the model's outputs to changes in key variables.
resultsHTO was most likely to be cost-effective in cohorts under 60, and UKA most likely in those 60 and over. Probabilistic results did not indicate one intervention to be significantly more cost-effective than another. The model was exquisitely sensitive to changes in utility (functional outcome), somewhat sensitive to changes in cost, and least sensitive to changes in 10-year revision risk.
conclusionsHTO may be the most cost-effective option when treating MCOA in younger patients, while UKA may be preferred in older patients. Functional utility is the primary driver of the cost-effectiveness of these interventions. For the clinician, this study supports HTO as a competitive treatment option in young patient populations. It also validates each one of the three interventions considered as potentially optimal, depending heavily on patient preferences and functional utility derived over time.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.