Costs of staged versus simultaneous bilateral total knee arthroplasty: a population-based study of the Taiwanese National Health Insurance Database

Abstract

BackgroundBilateral total knee arthroplasty (TKA) is required for many patients. There are few studies comparing the overall costs of staged and simultaneous bilateral TKA.MethodsThe Taiwan National Health Insurance Research Database (NHIRD) was searched, and the total medical costs of 452 patients who received simultaneous bilateral TKAs were compared with those of 690 who received staged bilateral TKAs.ResultsAll categories of medical costs were lower in the simultaneous TKA group, with the exception of therapeutic procedure fees which were higher in the simultaneous bilateral TKA group. The 10-year prosthesis survival rates for simultaneous and staged bilateral TKA were 90.9% and 87.5% (p > 0.05), respectively.ConclusionsThese results indicate that simultaneous bilateral TKA is more cost effective than staged bilateral TKA. Prosthesis survival is not affected by the choice for staged or simultaneous bilateral TKA.

Costs analysis of Staged Versus Simultaneous Bilateral Total Knee and Hip Arthroplasty: a university affiliated hospital survey of 1579 Chinese patients

“…Our results are consistent with previous studies, which have estimated the economy of simultaneous TKA or THA, compared with staged TKA or THA [2,[16][17][18][19]. A study from Taiwan demonstrated that all categories of medical costs, except for therapeutic procedure fees, were lower in the simultaneous TKA group [2].…”

“…Despite bilateral knee and hip arthroplasty being frequently performed, most studies paid attention to clinic outcomes, and only a few studies have been published recently on this topic. However, previous studies have not compared costs about THA, to say nothing of comparing costs when pooled both THA and TKA patients [2,7,12]. In this study, we compared the cost of simultaneous and staged procedures among TKA, THA, and their combination groups, found a signi cant difference between the two procedures in three groups.…”

“…Total Knee Arthroplasty (TKA) and Total Hip arthroplasty (THA) are cost-effective procedures for patients with advanced arthropathies, such as osteoarthritis (OA), rheumatoid arthritis (RA), and hip fracture, which can improve the quality of life for these patients signi cantly [1][2][3]. With the aging population, arthropathy incidence is projected to continue growing in many countries [2,[4][5][6]. A recent study from the U.S predicted the volume of total joint arthroplasty(TJA) and concluded that THA is projected to grow 71%, to 635,000 procedures, and TKA is projected to grow 85%, to 1.26 million procedures, by 2030 [4].…”

Simultaneous (two‐surgeon) versus staged bilateral knee arthroplasty: an observational study of intraoperative and post‐operative outcomes

“…Acute hospital LOS and total inpatient costs were lower for sim‐BTKA than staged BTKA, which is consistent with other studies, including recent studies on single‐anaesthetic BTKA that failed to distinguish between sim‐BTKA and sequential BTKA . Although a higher proportion of sim‐BTKA patients are discharged to inpatient rehabilitation which extends inpatient costs, acute hospital care is more expensive.…”

Simultaneous bilateral total knee arthroplasty in patients with haemophilia: a safe and cost‐effective procedure?

“…In haemophilia subgroup of patients, also, there has been a trend to perform multiple surgeries during a single operating session – the benefits being twofold . The costs of the factor replacement are shared for both procedures and the rehabilitation programme will be facilitated . Patients with haemophilia often suffer from multiple joint involvement (including bilateral knee arthropathy).…”