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

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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