Patients undergoing unicompartmental knee arthroplasty (UKA) receive superior value compared to those opting for primary total knee arthroplasty (TKA), largely due to reduced procedural costs without compromising patient-reported outcomes.
Cost Efficiency Drives Value Difference
A recent multi-institutional study analyzed 422 UKA cases matched against 1,266 primary TKAs to evaluate cost-effectiveness using time-driven activity-based costing alongside patient-reported Knee Osteoarthritis Outcome Score Physical Function Short-Form (KOOS-PS). The findings revealed that UKA procedures cost approximately 20.3% less than primary TKAs, translating to 674 cost units versus 811 cost units respectively. This significant cost disparity primarily underpins the higher value score observed for UKA.
Outcomes Remain Consistent Across Procedures
Despite the difference in costs, the improvement in KOOS-PS scores after one year post-surgery showed no significant variance between UKA and TKA groups, with UKA experiencing a 16.5-point increase and TKA a 16.1-point rise. This indicates that both surgical options offer similar enhancements in patient physical function, underscoring that the value advantage of UKA stems mainly from its lower financial burden rather than differences in clinical outcomes.
- UKA procedures are significantly less costly than TKAs, offering a 20.3% reduction in facility costs.
- Outpatient UKA remains more affordable, despite an 8.3% cost difference compared to outpatient TKA.
- Patient-reported outcomes show no meaningful difference between UKA and TKA after one year.
When considering outpatient surgeries, the cost advantage of UKA continues, albeit at a reduced margin of 8.3% compared to TKA. This suggests that while outpatient settings can mitigate some of the cost differences, UKA still retains its economic benefit over TKA.
Excluding revision, conversion, and robotic-assisted procedures ensured a focused comparison between standard UKA and primary TKA cases, providing a clear perspective on their respective cost-effectiveness without confounding variables.
Healthcare providers aiming to enhance value-based care should consider prioritizing UKA for patients with single compartment knee disease. This approach not only maintains patient satisfaction through equivalent functional outcomes but also supports the sustainability of healthcare resources by lowering procedural costs.
Maximizing healthcare value involves strategic decision-making that weighs both economic and clinical factors. The clear cost benefits associated with UKA, paired with comparable patient outcomes, make it a preferable option for suitable candidates. Implementing UKA more broadly where appropriate could lead to significant healthcare savings and improved resource allocation without sacrificing patient care quality.
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