High Costs Seen for Nonoperative Therapy for Late-Stage Knee Arthritis Prior to TKA

Differences seen in treatment prescribed and by gender, geography during the year before total knee arthroplasty
Self physiotherapy due to knee pain.
Self physiotherapy due to knee pain.Adobe Stock

WEDNESDAY, Oct. 5, 2022 (HealthDay News) -- Patients with late-stage knee osteoarthritis (OA) incur significant costs for nonoperative treatments in the year before total knee arthroplasty (TKA), and the type and cost of these treatments vary considerably, according to a study published online Sept. 20 in the Journal of Bone & Joint Surgery.

Darren Z. Nin, Ph.D., from New England Baptist Hospital in Boston, and colleagues used data from the IBM Watson Health MarketScan databases to identify 24,492 patients with late-stage knee OA who underwent unilateral, isolated primary TKA (2018 through 2019). Nonoperative procedures in the one-year period before surgery were evaluated.

The researchers found that the average total cost of nonoperative procedures per patient was $1,355. Intra-articular injections with corticosteroids (54.3 percent) were the most common nonoperative treatment prescribed, while the highest-cost, nonoperative procedure was intra-articular injections with hyaluronic acid ($1,019 per patient). Women had a higher total cost of nonoperative procedures versus men ($1,440 versus $1,254 per patient). There was also geographic variation noted, with the highest costs seen for patients in the Northeast ($1,740 per patient). More than half of patients had more than one nonoperative treatment (58.6 percent), while nearly one-third (32.0 percent) had three or more nonoperative treatments.

"For patients who eventually undergo TKA, the cost-effectiveness of these nonoperative treatments right before TKA needs to be carefully considered as the health care system transitions toward a value-based model," the authors write.

Several authors disclosed financial ties to the medical device industry.

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