Computer-Assisted Knee Arthroplasty Costs Evaluated

Procedure is less likely to be cost-effective at centers with low volume of joint replacements

MONDAY, July 14 (HealthDay News) -- The cost-effectiveness of computer-assisted surgery for total knee replacement depends on the annual hospital volume, with the technology providing less return on investment in lower-volume hospitals, according to a study published in the July issue of the Journal of Bone & Joint Surgery.

James D. Slover, M.D., of Massachusetts General Hospital in Boston, and colleagues used a Markov decision model to measure the impact of hospital volume on the cost-effectiveness of computer navigation in a theoretical cohort of 65-year-old knee arthroplasty patients with end-stage knee arthritis.

In order for computer navigation to be cost-effective, the researchers calculated that centers at which 250, 150 and 25 computer-navigated total knee arthroplasties are performed per year would need a reduction of the annual revision rate of 2 percent, 2.5 percent and 13 percent, respectively, over a 20-year period.

"Computer navigation is less likely to be a cost-effective investment in health care improvement in centers with a low volume of joint replacements, where its benefit is most likely to be realized," the authors conclude. "However, it may be a cost-effective technology for centers with a higher volume of joint replacements, where the decrease in the rate of knee revision needed to make the investment cost-effective is modest, if improvements in revision rates with the use of this technology can be realized."

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