Cost effectiveness of meniscal allograft for torn discoid lateral meniscus in young women

Ramme, Austin J.; Strauss, Eric J.; Jazrawi, Laith M.; Gold, Heather T.

doi:10.1080/00913847.2016.1197762

Cited by 13 publications

(15 citation statements)

References 28 publications

(50 reference statements)

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“…All included studies performed a cost-utility analysis (CUA) having quality-adjusted life years (QALYs) as outcome measurement[26–36,38–40], except for one, which consisted of a cost-effectiveness analysis (CEA) with outcome measured as years to total knee alloplastic (TKA) and the subsequent incremental cost-effectiveness ratio reported as cost per year to arthroplasty gained[37]. Nine of the studies performed model-based economic evaluations with input data from the best evidence available in the literature[26,29,30,32,33,36–39] while the remaining seven performed economic evaluations with data from clinical trials and cohort studies[27,28,31,34,35,40].…”

Section: Resultsmentioning

confidence: 99%

“…The time horizon of the studies varied from one year to lifetime. A societal perspective was adopted in eight of the studies[27–29,31,36,38,39,40] while five studies adopted a healthcare perspective or third payers’ perspective such as the National Health Service (NHS)[30,32,34,35,37]. The remaining two studies did not explicitly report the actual perspective[26,33].…”

Section: Resultsmentioning

confidence: 99%

“…The methodological quality of the studies by assessment of the CHEC list varied with nine of the studies rated as “high quality”[27,29,31,34–37,39,40] and the remaining six rated as “moderate quality”[26,28,30,32,33,38]. Most commonly, the inappropriately reported or missing items in the CHEC list was: 1) Time horizon, 2) perspective of the analysis, 3) discussion of the generalizability of the studies, and 4) discussion of ethical and distributional issues.…”

Section: Resultsmentioning

confidence: 99%

“…Both models showed ICER values above a WTP threshold of EUR 27.100 (Converted from 2016 GBP) per QALY, indicating that neither of the health technologies would be cost-effective. However, meniscal allografts have shown to reduce pain and improve function in patients with discoid lateral meniscus tears by a model-based CEA conducted by Ramme et al[37] when compared to partial meniscectomy. Over a 25-year period, a strategy of partial meniscectomy was less expensive compared to using meniscal allograft, but the meniscal allograft strategy postponed TKA by an average of 17.3 years compared to 12.5 years for partial meniscectomy.…”

Section: Resultsmentioning

confidence: 99%

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Cost-effectiveness of treatments for non-osteoarthritic knee pain conditions: A systematic review

et al. 2018

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IntroductionKnee pain is common in adolescents and adults and is associated with an increased risk of developing knee osteoarthritis. The aim of this systematic review was to gather and appraise the cost-effectiveness of treatment approaches for non-osteoarthritic knee pain conditions.MethodA systematic review was conducted according to the PRISMA guidelines and registered on PROSPERO (CRD42016050683). The literature search was done in MEDLINE via PubMed, EMBASE, The Cochrane Library, and the National Health Service Economic Evaluation Database. Study selection was carried out by two independent reviewers and data were extracted using a customized extraction form. Study quality was assessed using the Consensus on Health Economic Criteria list.ResultsFifteen studies were included. The majority regarded the treatment of anterior cruciate ligament (ACL) injuries, but we also identified studies evaluating other knee pain conditions such as meniscus injuries, cartilage defects, and patellofemoral pain syndrome. Study interventions were categorized as surgical or non-surgical interventions. The surgical interventions included ACL reconstruction, chondrocyte implantation, meniscus scaffold procedure, meniscal allograft transplantation, partial meniscectomy, microfracture, and different types of autografts and allografts. The non-surgical management consisted of physical therapy, rehabilitation, exercise, counselling, bracing, and advice. In general, for ACL injuries surgical management alone or in combination with rehabilitation appeared to be cost-effective. The quality of the economic evaluations was of moderate to high quality.ConclusionThere was insufficient evidence to give a firm overview of cost-effective interventions for non-osteoarthritic knee pain, but surgical treatment of acute ACL injury appeared cost-effective. There is very little data regarding the cost-effectiveness of non-surgical interventions for non-traumatic knee conditions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Cost-effectiveness of treatments for non-osteoarthritic knee pain conditions: A systematic review

et al. 2018

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“…This is known as a discoid cartilage, and may be more prone to injury. Ramme et al [ 37 ] compared the cost-effectiveness of MAT and partial meniscectomy in young women with torn discoid lateral meniscus and concluded that MAT was cost-effective.…”

Section: Introductionmentioning

confidence: 99%

Meniscal allograft transplantation after meniscectomy: clinical effectiveness and cost-effectiveness

Waugh

Mistry

Metcalfe

et al. 2019

Knee Surg Sports Traumatol Arthrosc

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Purpose To assess the clinical effectiveness and cost-effectiveness of meniscal allograft transplantation (MAT) after meniscal injury and subsequent meniscectomy. Methods Systematic review of clinical effectiveness and cost-effectiveness analysis. Results There is considerable evidence from observational studies, of improvement in symptoms after meniscal allograft transplantation, but we found only one small pilot trial with a randomised comparison with a control group that received non-surgical care. MAT has not yet been proven to be chondroprotective. Cost-effectiveness analysis is not possible due to a lack of data on the effectiveness of MAT compared to non-surgical care. Conclusion The benefits of MAT include symptomatic relief and restoration of at least some previous activities, which will be reflected in utility values and hence in quality-adjusted life years, and in the longer term, prevention or delay of osteoarthritis, and avoidance or postponement of some knee replacements, with resulting savings. It is likely to be cost-effective, but this cannot be proven on the basis of present evidence. Level of evidence IV. Electronic supplementary material The online version of this article (10.1007/s00167-019-05504-4) contains supplementary material, which is available to authorized users.

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Patients with advanced lateral osteoarthritis can return to sports and work after distraction arthroplasty plus lateral meniscal allograft transplantation combined with cartilage repair

Lee

Kim

Cho

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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PurposeThis study aimed to report return to sports (RTS) and return to work (RTW) outcomes after distraction arthroplasty (DA) plus lateral meniscal allograft transplantation (MAT) combined with cartilage repair in active patients with advanced osteoarthritis. It was hypothesised that DA combined with lateral MAT would improve clinical and radiological outcomes and enable RTS and RTW for most patients. MethodsIn total, 21 patients with advanced osteoarthritis (moderate to severe joint space narrowing at lateral edge on Rosenberg view and large cartilage defect of lateral femoral condyle) who underwent concomitant DA and MAT were retrospectively reviewed. Clinical outcomes were assessed using subjective knee scores [Lysholm score, International Knee Documentation Committee (IKDC) subjective knee score, and Tegner activity scale (TAS)] and functional tests (isokinetic extensor muscle strength test, single‐leg vertical jump test, and single‐leg hop for distance test). The rates of RTS, RTW, and satisfaction were evaluated. Radiological outcomes were assessed using magnetic resonance imaging (MRI) and X‐ray (Rosenberg view). ResultsThe mean age at surgery and mean follow‐up duration were 37.2 ± 5.9 years and 37.1 ± 5.4 months, respectively. All improvements in subjective scores were statistically significant (p < 0.001). The Lysholm score improved from 58.3 ± 8.1 to 84.3 ± 8.2, the IKDC subjective score from 53.9 ± 10.4 to 78.0 ± 7.7, and the TAS from 4.0 ± 0.5 to 5.1 ± 0.8. The limb symmetry index (LSI) (%) of the extensor peak torque at an angular velocity of 60°/s improved from 67.3 ± 19.2 to 88.4 ± 20.3% (p = 0.001). The LSI of the single‐leg vertical jump test and single‐leg hop for distance test improved from 62.8 ± 21.3 to 87.7 ± 19.5% and from 63.9 ± 20.8 to 85.5 ± 18.1%, respectively (all, p < 0.001). All patients were able to return to any sports activity and work. However, 67% and 90.5% returned to their defined or desired level of sports activity and occupation intensity, respectively. Further, 76.2% were very satisfied or somewhat satisfied with the outcome at the last follow‐up. The JSW increased by 0.8 ± 0.4 to 2.3 ± 0.6 mm (p = 0.005). In more than 90% of patients, > 50% of cartilage lesion was covered. The mean graft extrusion was 2.6 ± 1.0 mm. ConclusionAll patients who underwent distraction arthroplasty plus lateral MAT combined with cartilage repair returned to any sports and work at the last follow‐up. Significant improvements in clinical outcomes and the radiographic joint space width were observed. However, the activity ability was somewhat reduced compared with the best preoperative level. This one‐stage joint salvage treatment is a promising option for young and active patients with advanced OA who wish to return to high levels of sports activity and occupation intensity (≥ Tegner activity scale 4). Level of evidenceIII.

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Cost effectiveness of meniscal allograft for torn discoid lateral meniscus in young women

Cited by 13 publications

References 28 publications

Cost-effectiveness of treatments for non-osteoarthritic knee pain conditions: A systematic review

Cost-effectiveness of treatments for non-osteoarthritic knee pain conditions: A systematic review

Meniscal allograft transplantation after meniscectomy: clinical effectiveness and cost-effectiveness

Patients with advanced lateral osteoarthritis can return to sports and work after distraction arthroplasty plus lateral meniscal allograft transplantation combined with cartilage repair

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