Cost effectiveness and quality of life in knee arthroplasty.

Abstract:

:Few studies quantitate the cost of a quality well being as produced by arthroplasty surgery. The objective was to use the Quality of Well Being Index to calculate the cost per quality of well year in knee arthroplasty surgery. The difference in Quality of Well Being Index scores before and after the intervention was calculated and multiplied by the patient's life expectancy. The procedure cost was divided by this quantity resulting in the cost of a quality well year. One hundred patients underwent a primary knee arthroplasty. There were 30 males (average age, 62 years old) and 70 females (average age, 64 years old). The calculated costs per a quality well year were $30,695 (standard deviation $90,883) at 3 months, $17,804 (standard deviation $25,888) at 6 months, $11,560 (standard deviation $11,874) at 1 year, and $6656 (standard deviation $3567) at 2 years postsurgery. Health economists consider an intervention costing less than $30,000 per quality of well year a bargain to society. Cost effectiveness of knee arthroplasty surgery compares favorably with other surgical interventions such as coronary artery bypass surgery ($5000 per quality of well year) and extremely favorable with medical treatments such as renal dialysis ($50,000.00 for the quality well year). Knee arthroplasty is a cost effective procedure and should be considered an appropriate investment by society.

journal_name

Clin Orthop Relat Res

authors

Lavernia CJ,Guzman JF,Gachupin-Garcia A

subject

Has Abstract

pub_date

1997-12-01 00:00:00

pages

134-9

issue

345

eissn

0009-921X

issn

1528-1132

pub_type

杂志文章
  • John Charnley Award: Preoperative Patient-reported Outcome Measures Predict Clinically Meaningful Improvement in Function After THA.

    abstract:BACKGROUND:Despite the overall effectiveness of total hip arthroplasty (THA), a subset of patients remain dissatisfied with their results because of persistent pain or functional limitations. It is therefore important to develop predictive tools capable of identifying patients at risk for poor outcomes before surgery. ...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:10.1007/s11999-015-4350-6

    authors: Berliner JL,Brodke DJ,Chan V,SooHoo NF,Bozic KJ

    更新日期:2016-02-01 00:00:00

  • Clinical and hip simulator comparisons of ceramic-on-polyethylene and metal-on-polyethylene wear.

    abstract::The benefit of reduced polyethylene wear with ceramic in hip replacements does not seem to have been universally appreciated. In this current study, wear predictions from laboratory and clinical studies were compared for ceramic-on-polyethylene and cobalt chrome-on-polyethylene combinations. Many laboratory studies in...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章,评审

    doi:10.1097/00003086-200010000-00006

    authors: Clarke IC,Gustafson A

    更新日期:2000-10-01 00:00:00

  • Use of spinal traction in the treatment of neck and back conditions.

    abstract::Spinal traction is a time-honored method for the treatment of disc protrusion, degenerative disc disease, and joint dysfunction. Effective treatment is not as easy or as simple to administer as it may appear. Many variations of technique exist, some of questionable value. It must be emphasized that spinal traction is ...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:

    authors: Saunders HD

    更新日期:1983-10-01 00:00:00

  • Comparison of patellar resurfacing versus nonresurfacing in bilateral total knee arthroplasty.

    abstract::Twenty-five patients who received bilateral total knee prostheses were studied to evaluate the advantages and disadvantages of patellar resurfacing. Only patients with advanced patellofemoral disease were included in the study. In all patients, patellar resurfacing had been done in the right knee but not in the left k...

    journal_title:Clinical orthopaedics and related research

    pub_type: 临床试验,杂志文章

    doi:

    authors: Enis JE,Gardner R,Robledo MA,Latta L,Smith R

    更新日期:1990-11-01 00:00:00

  • Subchondral insufficiency fracture of the femoral head may be associated with hip dysplasia: a pilot study.

    abstract:BACKGROUND:Subchondral insufficiency fracture of the femoral head occurs mainly in elderly patients with osteoporosis. Spontaneous resolution is observed after nonoperative treatment in some patients whereas other show progressive joint destruction requiring THA. Several studies report the occurrence of subchondral ins...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:10.1007/s11999-009-1213-z

    authors: Ishihara K,Miyanishi K,Ihara H,Jingushi S,Torisu T

    更新日期:2010-05-01 00:00:00

  • Cemented all polyethylene tibial components in patients age 75 years and older.

    abstract::Between 1976 and 1980, 81 knees in 59 patients 75 years of age or older, underwent primary total knee arthroplasty with a cemented, condylar femoral component and a cemented, moderately conforming, all polyethylene tibial component. All patients were followed up until death, revision surgery, or for a minimum of 10 ye...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:

    authors: Pagnano MW,Levy BA,Berry DJ

    更新日期:1999-10-01 00:00:00

  • Thirty-day Postoperative Complications After Surgery For Metastatic Long Bone Disease Are Associated With Higher Mortality at 1 Year.

    abstract:BACKGROUND:The benefits of surgical treatment of a metastasis of the extremities may be offset by drawbacks such as potential postoperative complications. For this group of patients, the primary goal of surgery is to improve quality of life in a palliative setting. A better comprehension of factors associated with comp...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:10.1097/CORR.0000000000001036

    authors: Bindels BJJ,Thio QCBS,Raskin KA,Ferrone ML,Lozano Calderón SA,Schwab JH

    更新日期:2020-02-01 00:00:00

  • Where should implants be anchored in the humeral head?

    abstract::To determine histomorphometric and bone strength distribution of the proximal humerus, analyses were done on 24 freshly harvested human cadaveric humeri. Median ages of 46 and 69 years were recorded respectively for the male group (n = 11; minimum, 34 years; maximum, 76 years) and the female group (n = 13; minimum, 46...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:10.1097/01.blo.0000092968.12414.a8

    authors: Hepp P,Lill H,Bail H,Korner J,Niederhagen M,Haas NP,Josten C,Duda GN

    更新日期:2003-10-01 00:00:00

  • Traumatic hip dislocation in children. Long-term followup of 42 patients.

    abstract::To assess the impact of traumatic hip dislocations in the skeletally immature patient, 42 children younger than 16 years of age (average age, 9 years 10 months) who were treated at the authors' institution were studied. Data were collected from charts and radiographs and by completion of questionnaires. The average fo...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:

    authors: Mehlman CT,Hubbard GW,Crawford AH,Roy DR,Wall EJ

    更新日期:2000-07-01 00:00:00

  • Dorsal wrist ligament insertions stabilize the scapholunate interval: cadaver study.

    abstract::This study examined sequential arthroscopic sectioning of volar, interosseous, and dorsal ligaments about the scapholunate complex in cadaver wrists. We attempted to clarify the contributions of the dorsal ligamentous complex to scapholunate instability and carpal collapse. We found that after sequential sectioning of...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:10.1097/01.blo.0000136836.78049.45

    authors: Elsaidi GA,Ruch DS,Kuzma GR,Smith BP

    更新日期:2004-08-01 00:00:00

  • Total femur replacement procedures in tumor treatment.

    abstract:UNLABELLED:Replacement of bone segments after resection of a tumor-containing bone has a long history, and currently metallic implants and allografts have reasonable rates of success in terms of patient survival and restoration of useful function. Total femoral resections for extensive tumors are uncommon but clearly r...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:10.1097/00003086-200509000-00012

    authors: Mankin HJ,Hornicek FJ,Harris M

    更新日期:2005-09-01 00:00:00

  • What middle phalanx base fracture characteristics are most reliable and useful for surgical decision-making?

    abstract:BACKGROUND:Fracture-dislocations of the proximal interphalangeal joint are vexing because subluxation and articular damage can lead to arthrosis and the treatments are imperfect. Ideally, a surgeon could advise a patient, based on radiographs, when the risk of problems merits operative intervention, but it is unclear i...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:10.1007/s11999-015-4394-7

    authors: Janssen SJ,Molleman J,Guitton TG,Ring D,Science Of Variation Group.

    更新日期:2015-12-01 00:00:00

  • Osteochondritis dissecans following Perthes' disease.

    abstract::Patients with Perthes' disease develop a lesion comparable to osteochondritis dissecans (OCD). The frequency of this combination was about 6% of all Perthes' disease patients conservatively treated. In three out of 17 patients reported here, the lesion caused minor symptoms, but was associated with dislocation, loose ...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:

    authors: Osterman K,Lindholm TS

    更新日期:1980-10-01 00:00:00

  • Congenital hip dislocation. Long-range problems, residual signs, and symptoms after successful treatment.

    abstract::In the treatment of congenital dislocation of the hip, reduction must be obtained and maintained to provide the proper stimulus for resumption of normal hip joint growth and development. Subluxation and avascular necrosis must be avoided, as degenerative joint disease is certain to occur. Acetabular dysplasia leads to...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:

    authors: Weinstein SL

    更新日期:1992-08-01 00:00:00

  • Bone marrow aspirate concentrate and platelet-rich plasma enhanced bone healing in distraction osteogenesis of the tibia.

    abstract:BACKGROUND:During lower limb lengthening, poor bone regeneration is a devastating complication. Several local or systemic applications have been used to promote osteogenesis, and biologic stimulations are gaining attention, but their utility has not been proven in this setting. QUESTIONS/PURPOSES:In patients undergoin...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章,随机对照试验

    doi:10.1007/s11999-014-3548-3

    authors: Lee DH,Ryu KJ,Kim JW,Kang KC,Choi YR

    更新日期:2014-12-01 00:00:00

  • The effect of increased tissue pressure on blood flow.

    abstract::Theoretical consideration of the factors involved in maintaining vascular equilibrium and experimental evidence in animals and man indicate that at high tissue pressures there may be a sharp decline in blood flow and, in certain situations, complete cessation of blood flow even at tissue pressures below mean arterial ...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:10.1097/00003086-197511000-00004

    authors: Ashton H

    更新日期:1975-11-01 00:00:00

  • Solitary fibrous tumor in the extremity: case report and review of the literature.

    abstract::A solitary fibrous tumor is a relatively unusual neoplasm first described as a distinctive tumor arising from pleura. Some reports have shown that solitary fibrous tumors also affect extrathoracic regions. The current study presents a literature review with four additional patients with solitary fibrous tumor arising ...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章,评审

    doi:10.1097/01.blo.0000065839.77325.b4

    authors: Akisue T,Matsumoto K,Kizaki T,Fujita I,Yamamoto T,Yoshiya S,Kurosaka M

    更新日期:2003-06-01 00:00:00

  • Effects of different commercial diets on several orthopedic experiments.

    abstract::In experiments involving disuse osteoporosis induced by plaster cast immobilization, 2 commonly used commercial feeds (Wayne Lab Blox and Purina Laboratory Chow) gave different results. Preliminary evidence suggests that this dichotomy of results is due to an interaction between metabolic changes caused by physiologic...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:

    authors: Martin RB

    更新日期:1979-01-01 00:00:00

  • Computer-aided design and computer-aided manufacturing (CAD/CAM) in prosthetics.

    abstract::Computer-aided design and computer-aided manufacturing (CAD/CAM) systems for the design and manufacture of limb prostheses have recently become commercially available. However, rigorous evaluations of these systems have not been performed to determine whether they produce sockets that fit as well as or better than soc...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:

    authors: Topper AK,Fernie GR

    更新日期:1990-07-01 00:00:00

  • A simple technique for internal fixation of the clavicle. A long term evaluation.

    abstract::A simple, effective technique for internal fixation of the clavicle with Knowles threaded pins is described in 11 patients with 1 to 21 year results. The method is applicable to fresh fractures of non-union and provides secure compression-fixation. The threads prevent migration of the pin, reduce the period of externa...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:10.1097/00003086-197506000-00013

    authors: Neviaser RJ,Neviaser JS,Neviaser TJ,Neviaser JS

    更新日期:1975-01-01 00:00:00

  • The use of bone allografts in the spine.

    abstract::Bone allografts are commonly used in spinal surgery. Structural allografts placed anteriorly in the spine may be used as interbody grafts or as strut grafts spanning multiple segments. Posterior allografts are used to supplement autologous bone for spinal fusions in patients who lack sufficient host bone and to avoid ...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章,评审

    doi:10.1097/00003086-199603000-00010

    authors: Buttermann GR,Glazer PA,Bradford DS

    更新日期:1996-03-01 00:00:00

  • Rapid recovery protocols and minimally invasive surgery help achieve high knee flexion.

    abstract::Although the primary goal of total knee arthroplasty is to relieve pain, the attainment of high flexion has emerged as an important secondary goal. Clinical pathways are evolving and focus on rapid recovery. The entire perioperative process for the patient and family, including office and hospital procedures, has been...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:10.1097/01.blo.0000238824.56024.7a

    authors: Lombardi AV Jr,Viacava AJ,Berend KR

    更新日期:2006-11-01 00:00:00

  • Is a sliding hip screw or im nail the preferred implant for intertrochanteric fracture fixation?

    abstract:UNLABELLED:This study was performed to determine whether patients who sustain an intertrochanteric fracture have better outcomes when stabilized using a sliding hip screw or an intramedullary nail. A 20% sample of Part A and B entitled Medicare beneficiaries 65 years or older was used to generate a cohort of patients w...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章,多中心研究

    doi:10.1007/s11999-008-0285-5

    authors: Aros B,Tosteson AN,Gottlieb DJ,Koval KJ

    更新日期:2008-11-01 00:00:00

  • Traumatic kyphosis of the thoracolumbar spine.

    abstract::The rationale of acute and chronic orthopedic management of traumatic throacolumbar kyphosis is determined by the type and location of the injury. The performance of laminectomy is condemned due to its historical failure in both the acute and chronic phase and its violation of simple mechanical principles. ...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:

    authors: Whitesides TE Jr

    更新日期:1977-10-01 00:00:00

  • Bone mineral density changes in distracted callus stimulated by pulsed direct electrical current.

    abstract::To evaluate the effect of application of pulsed direct current electrical stimulation to callus tissue, a 1-cm bone-lengthening model using an external lengthener was applied to rabbit tibia. Twenty-microampere pulsed direct current was applied 12 hours daily from the day of osteotomy until 40 days after the completio...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:

    authors: Hamanishi C,Kawabata T,Yoshii T,Tanaka S

    更新日期:1995-03-01 00:00:00

  • Irreducible intertrochanteric fractures of the femur.

    abstract::A retrospective study during a 3-year interval revealed that four of 112 patients had intertrochanteric fractures that were irreducible by the usual closed manipulation and traction techniques at the time of surgery. Each of these patients' preoperative radiographs showed a fracture line that bisected the lesser troch...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:10.1097/00003086-199706000-00027

    authors: Moehring HD,Nowinski GP,Chapman MW,Voigtlander JP

    更新日期:1997-06-01 00:00:00

  • Total hip arthroplasty for avascular necrosis of the femur in systemic lupus erythematosus.

    abstract::Six patients with systemic lupus erythematosus and avascular necrosis of the femoral head were treated by total hip arthroplasty (THA). The primary indication for surgery was persistent hip pain despite conservative therapy. Postoperatively, pain was relieved with corresponding improvement in range of motion in all si...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:

    authors: Prupas HM,Patzakis M,Quismorio FP Jr

    更新日期:1981-11-01 00:00:00

  • Telangiectatic osteogenic sarcoma. Improved survival with combination chemotherapy.

    abstract::Since the inception of adjuvant chemotherapy for osteogenic sarcoma (OS), 25 patients were treated for telangiectatic osteogenic sarcoma (TOS) from 1973 through 1980. This represented 12% of all patients with primary OS of an extremity seen during this time period. Tumors that demonstrated only focal areas of TOS with...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:

    authors: Rosen G,Huvos AG,Marcove R,Nirenberg A

    更新日期:1986-06-01 00:00:00

  • Professionalism and professional values in orthopaedics.

    abstract::During a consensus conference in Fall, 1998, the Academic Orthopaedic Society identified the values and qualities of professionalism as defined by its members. One hundred eighty-six respondents rated 20 characteristics and values describing professionalism, based on the extent to which they believed each item was app...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:10.1097/00003086-200009000-00015

    authors: Rowley BD,Baldwin DC Jr,Bay RC,Karpman RR

    更新日期:2000-09-01 00:00:00

  • The John Charnley Award. Natural history of thromboembolic disease after total hip arthroplasty.

    abstract::In 1079 consecutive patients undergoing total hip arthroplasty between 1984 and 1992, complications of thromboembolic disease and related anticoagulation were reviewed for 6 months after hospital discharge, including cost data. Of 347 patients having venograms, 78 (22.5%) had positive results and 269 (77.5%) had negat...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:

    authors: Pellegrini VD Jr,Clement D,Lush-Ehmann C,Keller GS,Evarts CM

    更新日期:1996-12-01 00:00:00