Evidence map›Paper›PMID 30721344›Full record

SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2019

The cost-effectiveness of osteochondral allograft transplantation in the knee.

Hema Mistry, Andrew Metcalfe, Nick Smith, Emma Loveman, Jill Colquitt, Pamela Royle, Norman Waugh

Open access · hybridAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 1 pooled it
5.0field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.

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  17. Patient-specific metal implants for focal chondral and osteochondral lesions in the knee; excellent clinical results at 2 years.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2021
    Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Hema MistryDivision of Health Sciences, Warwick Medical School, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK. Hema.Mistry@warwick.ac.uk.ORCID http://orcid.org/0000-0002-5023-1160
Andrew MetcalfeWarwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
Nick SmithUniversity Hospitals Coventry and Warwickshire, Coventry, CV2 2DX, UK.
Emma LovemanEffective Evidence LLP, 26 The Curve, Waterlooville, Hampshire, PO8 9SE, UK.
Jill ColquittEffective Evidence LLP, 26 The Curve, Waterlooville, Hampshire, PO8 9SE, UK.
Pamela RoyleDivision of Health Sciences, Warwick Medical School, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK.
Norman WaughDivision of Health Sciences, Warwick Medical School, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK.
University of Warwick · GBUniversity Hospitals Coventry and Warwickshire NHS Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeOsteochondral allografts (OCA) consist of a layer of hyaline cartilage and a layer of underlying bone. They are used to repair combined defects of articular cartilage and bone. Such defects often occur in people far too young to have knee arthroplasty, for whom the main alternative to OCA is conservative symptomatic care, which will not prevent development of osteoarthritis. The aim of this report was to assess the cost-effectiveness of osteochondral allograft transplantation in the knee.

methodsSystematic review of evidence on clinical effectiveness and economic modelling.

resultsThe evidence on osteochondral allograft transplantation comes from observational studies, but often based on good quality prospective registries of all patients having such surgery. Without controlled trials, it was necessary to use historical cohorts to assess the effect of osteochondral grafts. There is good evidence that OCA are clinically effective with a high graft survival rate over 20 years. If an OCA graft fails, there is some evidence that revision with a second OCA is also effective, though less so than primary OCA. Economic modelling showed that osteochondral allograft transplantation was highly cost-effective, with costs per quality adjusted life year much lower than many other treatments considered cost effective.

conclusionsOsteochondral allograft transplantation appears highly cost-effective though the cost per quality adjusted life year varies according to the widely varying costs of allografts. Based on one small study, revision OCA also appears very cost-effective, but more evidence is needed. LEVEL OF EVIDENCE: II.

Indexed as

Graft SurvivalAllograftsBone TransplantationCartilageCost-Benefit AnalysisHumansKnee JointModels, EconomicQuality-Adjusted Life YearsReoperationAllograftsCost-effectivenessOsteochondralSystematic review

Identifiers

PMID30721344
PMCPMC6541582
OpenAlexW2914444854

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.