ArticleJournal of experimental orthopaedics2024
Forecasting the value of innovation in total knee arthroplasty care: A headroom approach.
Article in Journal of experimental orthopaedics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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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.
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Who cites it
3 citing papers in PubMed.
- Simultaneous bilateral total knee arthroplasty with and without patellar resurfacing using a zirconium ceramic femoral component demonstrated equivalent short-term outcomes: A prospective randomised clinical trial.Journal of experimental orthopaedics · 2025Article
- The projected economic burden and complications of revision hip and knee arthroplasties: Insights from national registry studies.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Review
- Forecasting the value of innovation in total knee arthroplasty care: A headroom approach.Journal of experimental orthopaedics · 2024Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: Total knee arthroplasty (TKA) is the standard treatment of end-stage osteoarthritis. TKA is often used and, therefore, poses a healthcare and societal burden, which is likely to increase further. Headroom analyses evaluate a technology under development by making assumptions about its effectiveness. This article applies a headroom approach to forecast the potential value of innovations that improve TKA-related care in the Netherlands in terms of cost-effectiveness and surgeries avoided. Methods: A state-transition model estimating lifetime direct health effects, healthcare- and societal costs and percentage of avoide d surgeries was developed. The model compared care as usual to five hypothetical interventions to calculate the headroom associated with (1) preventing the need for TKAs, (2) preventing the need for all TKA revisions, (3) postponing TKAs without quality-of-life loss, (4) preventing periprosthetic joint infections (PJIs) and (5) improving patient satisfaction. Results: Preventing the need for all TKAs amounted to €43,076 of headroom. Preventing the need for TKA revisions amounted to €2276 (5.8% of surgeries avoided), postponing TKAs by 5 years amounted to €7634 (32.4% of surgeries avoided), preventing PJIs amounted to €1187 (1.4% of surgeries avoided) and improving patient satisfaction amounted to €16,622 (0% of surgeries avoided). The headroom of each hypothetical intervention was highest in younger populations (<50 years of age). Conclusion: There is a headroom for improving TKA-related care. Innovations to avoid or postpone TKA (i.e., joint-preserving treatments) as well as those that improve patient satisfaction can be effective in maximizing the value for money and avoiding surgeries. Due to the decreasing average patient age, innovations to reduce revision rates and PJIs will become more valuable as these are most effective in younger patients. It is currently unclear how cost-effectiveness considerations should be traded off against the prevention of surgery to reduce the increasing burden on the healthcare system. Level of Evidence: Level III economic evaluation/decision-analytic model.
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