Evidence map›Paper›PMID 35179519›Full record

ArticleJournal of the American Academy of Orthopaedic Surgeons. Global research & reviews2022

Analysis of the Cost and Efficacy of Intra-Articular Knee Injections.

Sean Pirkle, Henry Seidel, Sarah Bhattacharjee, Lewis L Shi, Michael J Lee, Jason A Strelzow

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Article in Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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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

6 authors.

Sean PirkleFrom the Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA (Pirkle); the Pritzker School of Medicine, University of Chicago, Chicago, IL (Seidel, Bhattacharjee); and the Department of Orthopaedic Surgery and Rehabilitative Medicine, University of Chicago Medicine, Chicago, IL (Shi, Lee, and Strelzow).ORCID 0000-0002-3038-1428
Sarah Bhattacharjee
Michael J Lee

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionIntra-articular joint injections have been used with the goal of providing patients with symptomatic relief. Recently, however, the efficacy of corticosteroid (CS) and hyaluronic acid (HA) injections in the management of knee osteoarthritis (OA) is questionable. In this analysis, we investigated the costs associated with injections by assessing overall use, conversion and average time to total knee arthroplasty (TKA), and reimbursement.

methodsPatients aged 50 to 70 years with a knee-related diagnosis of pain, effusion, or OA were identified in the Humana insurance national data set. Patients who received intra-articular injections were stratified by the type and number of injection(s) received. The subsequent rates of TKA were compared with Kaplan-Meier curves for patients who underwent CS injections, HA injections, and a benchmarking cohort of patients with OA and no history of knee injections in the medical record. Average time to TKA was determined from index diagnosis, and total cost was compared using Wilcoxon rank sum analyses.

resultsA total of 778,686 patients were identified. Of these, 637,112 had no knee injection history, while 124,129 received CS and 17,445 received HA injections. The 10-year conversion to TKA was highest in HA cohort (31.6%), followed by the CS cohort (24.0%) and the noninjection cohort (7.3%) (P < 0.001). Time to TKA increased with number of injections for both injection types. For patients who underwent TKA, median cost was greater in HA ($16,687) and CS ($15,563) cohorts relative to noninjection cohort ($14,733) (P < 0.001). DISCUSSION: Compared with the noninjection cohort, both HA and CS cohorts experienced increased costs and increased time to TKA. However, while the cost incurred in HA cohort was greater than that in CS cohort, no appreciable benefit was demonstrated for conversion or time to TKA. Therefore, if intra-articular knee injections are indicated for the nonsurgical management of knee OA, the results of this study support CS over HA.

Indexed as

Arthroplasty, Replacement, KneeOsteoarthritis, KneeAgedHumansHyaluronic AcidInjections, Intra-ArticularKnee JointMiddle AgedHyaluronic Acid

Identifiers

PMID35179519
PMCPMC10566983

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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.