Primary total ankle replacement surgery is a cost-effective intervention
| Autor: | Zach J. Place, Nicholas D. Clement, Deborah MacDonald, John McKinley, Hisham Shalaby |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Cost-Benefit Analysis Ankle replacement Arthroplasty Replacement Ankle Quality of life Intervention (counseling) Surveys and Questionnaires medicine Humans Orthopedics and Sports Medicine Podiatry Socioeconomic status Aged business.industry Arthroplasty medicine.anatomical_structure Cohort Physical therapy Quality of Life Female Quality-Adjusted Life Years General Health Questionnaire Ankle business |
| Zdroj: | Foot (Edinburgh, Scotland). 49 |
| ISSN: | 1532-2963 |
| Popis: | Aims The primary aim was to assess the cost-effectiveness of primary total ankle replacements (PTAR) in the UK. Secondary aim was to identify predictors associated with increased cost-effectiveness of PTAR. Methods Pre-operative and six-month post-operative data was obtained over a 90-month period across the two centres receiving adult referrals in the UK. The EuroQol general health questionnaire (EQ-5D-3L) measured health-related Quality of Life (HRQoL) and the Manchester-Oxford Foot Questionnaire (MOXFQ) measured joint function. Predictors, tested for significance with QALYs gained, were pre-operative scores and demographic data including age, gender, BMI and socioeconomic status. A cost per QALY of less than £20,000 was defined as cost effective. Results The 51-patient cohort [mean age 67.70 (SD 8.91), 58.8% male] had 47.7% classed as obese or higher. Cost per QALY gained was £1669, rising to £4466 when annual (3.5%) reduction in health gains and revision rates and discounting were included. Lower pre-operative EQ-5D-3L index correlated significantly with increased QALYs gained (p 0.05) associated with QALYs gained. Conclusions PTAR is a cost-effective intervention for treating end-stage ankle arthritis. Pre-operative EQ-5D-3L was associated with QALYs gained. A pre-operative EQ-5D-3L score of 0.57 or more was not cost effective to operate on. |
| Databáze: | OpenAIRE |
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