Evidence map›Paper›PMID 36905414›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2023

Routine use of antibiotic-laden bone cement in total knee arthroplasty is a cost-effective practice in the single-payer healthcare system.

Hassaan Abdel Khalik, Thomas J Wood, Daniel M Tushinski, Aaron Gazendam, Danielle T Petruccelli, Kamal Bali, Hamilton Arthroplasty Group, Mitchell Winemaker, Victoria Avram, Justin de Beer and 3 more

Abstract read
PubMed Publisher
In one paragraph

Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.5field-weighted citation impact, top 11% 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

5 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Review
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

13 authors at 2 institutions in 1 country.

Hassaan Abdel KhalikDivision of Orthopaedic Surgery, McMaster University, 1280 Main Street West, Hamilton, ON, L8N 3Z5, Canada. Hassaan.abdel-khalik@medportal.ca.ORCID http://orcid.org/0000-0002-1711-515X
Thomas J WoodDivision of Orthopaedic Surgery, McMaster University, 1280 Main Street West, Hamilton, ON, L8N 3Z5, Canada.
Daniel M TushinskiDivision of Orthopaedic Surgery, McMaster University, 1280 Main Street West, Hamilton, ON, L8N 3Z5, Canada.
Aaron GazendamDivision of Orthopaedic Surgery, McMaster University, 1280 Main Street West, Hamilton, ON, L8N 3Z5, Canada.
Danielle T PetruccelliDivision of Orthopaedic Surgery, McMaster University, 1280 Main Street West, Hamilton, ON, L8N 3Z5, Canada.
Kamal BaliDivision of Orthopaedic Surgery, McMaster University, 1280 Main Street West, Hamilton, ON, L8N 3Z5, Canada.
Hamilton Arthroplasty Group
Mitchell Winemaker
Victoria Avram
Justin de Beer
Dale Williams
Laura Puri
Liz Piccirillo
Juravinski Hospital · CAMcMaster University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe purpose of this study was to determine the cost-effectiveness of antibiotic-laden bone cement (ALBC) in primary total knee arthroplasty (TKA) from the perspective of a single-payer healthcare system.

methodsA cost-utility analysis (CUA) was performed over a 2-year time horizon comparing primary TKA with either ALBC or regular bone cement (RBC) from the perspective of the single-payer Canadian healthcare system. All costs were in 2020 Canadian dollars. Health utilities were in the form of quality-adjusted life years (QALYs). Model inputs for cost, utilities and probabilities were derived from the literature as well as regional and national databases. One-way deterministic sensitivity analysis was performed.

resultsPrimary TKA with ALBC was found to be more cost-effective compared to primary TKA with RBC with an incremental cost-effectiveness ratio (ICER) of -3,637.79 CAD/QALY. The use of routine ALBC remained cost-effective even with cost increases of up to 50% per bag of ALBC. TKA with ALBC was no longer cost-effective if the rate of PJI following this practice increased 52%, or the rate of PJI following the use of RBC decreased 27%.

conclusionsThe routine use of ALBC in TKA is a cost-effective practice in the single-payer Canadian healthcare system. This remains to be the case even with a 50% increase in the cost of ALBC. Policy makers and hospital administrators of single-payer healthcare systems can leverage this model to inform their local funding policies. Future prospective reviews and randomized controlled trials from the perspective of various healthcare models can further shed light on this issue. LEVEL OF EVIDENCE: III.

Indexed as

Arthroplasty, Replacement, KneeProsthesis-Related InfectionsAnti-Bacterial AgentsBone CementsCanadaCost-Benefit AnalysisDelivery of Health CareHumansAnti-Bacterial AgentsBone CementsAntibiotic-laden bone cementCost-effectivenessCost-utility analysisHealth economicsInfection prophylaxisPeriprosthetic joint infectionSurgical site infectionTotal knee arthroplasty

Identifiers

PMID36905414
OpenAlexW4323921140

What OpenQuestion holds

Textmetadata
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.