Direct treatment cost outcomes among patients with medial meniscus deficiency: results from a 24-month surveillance study

Hershman, Elliott B.; Jarvis, John; Mick, T.; Dushaj, Kristina; Elsner, Jonathan J.

doi:10.1080/03007995.2020.1713073

Cited by 5 publications

(9 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The general characteristics of the included studies are presented in Table 1. A total of 16 studies were identified and included; six performed PEEs [7,[14][15][16][17][18], seven CUAs [6,[19][20][21][22][23][24], two CEA [25,26], and one study performed a CUA, CEA, and CBA simultaneously [12]. Five studies compared meniscus repair vs meniscectomy [6,7,19,20,22], three studies compared costs of meniscectomy vs non-operative treatment [14,17,24], two studies compared physical therapy with delayed meniscectomy vs early meniscectomy [12,21], two studies directly compared the costs of having vs not having physical therapy after a meniscectomy [15,16], three studies investigated meniscus transplantation, and one study compared costs associated with conventional arthroscopic instruments vs laser-assisted treatment in meniscectomy [18].…”

Section: General Characteristics Of Included Studiesmentioning

confidence: 99%

Health-economic evaluation of meniscus tear treatments: a systematic review

Deviandri

Daulay

Iskandar

et al. 2023

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

Purpose To evaluate the overall evidence of published health-economic evaluation studies on meniscus tear treatment. Methods Our systematic review focuses on health-economic evaluation studies of meniscus tear treatment interventions found in PubMed and Embase databases. A qualitative, descriptive approach was used to analyze the studies’ results and systematically report them following PRISMA guidelines. The health-economic evaluation method for each included study was categorized following one of the four approaches: partial economic evaluation (PEE), cost-effectiveness analysis (CEA), cost–benefit analysis (CBA), or cost-utility analysis (CUA). The quality of each included study was assessed using the Consensus on Health Economic Criteria (CHEC) list. Comparisons of input variables and outcomes were made, if applicable. Results Sixteen studies were included; of these, six studies performed PEE, seven studies CUA, two studies CEA, and one study combined CBA, CUA, and CEA. The following economic comparisons were analyzed and showed the respective comparative outcomes: (1) meniscus repair was more cost-effective than arthroscopic partial meniscectomy (meniscectomy) for reparable meniscus tear; (2) non-operative treatment or physical therapy was less costly than meniscectomy for degenerative meniscus tear; (3) physical therapy with delayed meniscectomy was more cost-effective than early meniscectomy for meniscus tear with knee osteoarthritis; (4) meniscectomy without physical therapy was less costly than meniscectomy with physical therapy; (5) meniscectomy was more cost-effective than either meniscus allograft transplantation or meniscus scaffold procedure; (6) the conventional arthroscopic instrument cost was lower than laser-assisted arthroscopy in meniscectomy procedures. Conclusion Results from this review suggest that meniscus repair is the most cost-effective intervention for reparable meniscus tears. Physical therapy followed by delayed meniscectomy is the most cost-effective intervention for degenerative meniscus tears. Meniscus scaffold should be avoided, especially when implemented on a large scale. Level of evidence Systematic review of level IV studies.

show abstract

Section: General Characteristics Of Included Studiesmentioning

confidence: 99%

Health-economic evaluation of meniscus tear treatments: a systematic review

Deviandri

Daulay

Iskandar

et al. 2023

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

show abstract

“…Previous work has been carried out exploring the economic impact of treating meniscal tear patients with meniscectomy compared with non-surgical management. Hershman et al carried out a single-centre, prospective, observational study over a 24-month period in the US to evaluate the direct treatment costs associated with carrying out a meniscectomy on patients compared with non-surgical treatment [ 48 ]. Based on their analysis involving 50 patients, they found that direct costs among those patients who received a meniscectomy were higher on average than among the non-surgical cohort ($4562 [SD $1151] compared with $1792 [SD $1576]) [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness Analysis of a Medial Meniscus Replacement Prosthesis for the Treatment of Patients with Medial Compartment Pain in the United Kingdom

Javanbakht

Mashayekhi

Carlson

et al. 2022

PharmacoEconomics Open

View full text Add to dashboard Cite

Background The most common intra-articular knee injury is a meniscal tear, which commonly occurs secondary to trauma following twisting or hyperflexion. Treatment options for meniscal tears can either be surgical or non-surgical, and range from rest, exercise, bracing and physical therapy to surgical intervention, including meniscal repair and partial meniscectomy. In patients with persistent pain following loss of meniscus tissue, treatment can include partial replacement or meniscal allograft transplantation. The NUsurface ® prosthesis has been developed as a treatment option for patients experiencing persistent knee pain post medial meniscus (MM) surgery. Objective The aim of this study was to assess the cost effectiveness of MM replacement using NUsurface for the treatment of patients with medial compartment pain following previous partial medial meniscectomy, from a UK health service perspective. Methods An economic decision-analytic model was developed to assess the cost per quality-adjusted life-year (QALY) gained associated with the introduction of MM replacement using NUsurface compared with non-surgical standard of care, over a lifetime time horizon. The model structure was primarily informed by a previous clinical trial (VENUS) and was developed based on the clinical pathways typically followed by patients with this condition, with treatment pathways and probabilities of clinical progression adjusted depending on whether patients were receiving the intervention or undergoing current practice. A hypothetical cohort of adult patients (mean age of 50 years) was modelled, with clinical data sourced from the VENUS study as well as relevant UK literature. Both deterministic and probabilistic sensitivity analyses were carried out to explore uncertainty in the model results. Results The base-case probabilistic results indicate that MM replacement using NUsurface is likely to be cost effective across a range of willingness-to-pay (WTP) thresholds (95% probability of being cost effective at the National Institute for Health and Care Excellence (NICE)-recommended £20,000 WTP threshold). Although per-patient costs increase, QALYs are also gained, with the incremental cost per QALY (probabilistic value = £5011) being below £20,000. Deterministic sensitivity analyses indicate that the parameters that have the greatest impact on results are the failure rate in the control group (current practice), utility scores, and the cost of undergoing MM replacement using NUsurface. Conclusions Based on the analysis presented, MM replacement with the NUsurface prosthetic implant is likely to be a cost-effective use of UK health care service resources compared with current standard care. Supplementary Information The online version contains supplementary material available at 10.1007/s41669-022-00336-4.

show abstract

“…84 The highest cost patients in this group were the ones who started in the nonoperative group and went on to total knee arthroplasty ($32,197). 84 An insurance database study had contradicting results showing much lower cost of physical therapy ($411 vs. $3843). 85 In this study, more meniscectomy patients went on to total knee arthroplasty compared with the nonoperative group (11.4% vs. 9.5%).…”

Section: Surgical Versus Nonoperative Managementmentioning

confidence: 95%

“…It is important to note that the average age in this population was 57 and the majority of meniscus tears were complex degenerative tears. In an analysis of 50 patients who underwent partial meniscectomy or nonoperative management, 24-month direct costs were comparable at $4488 in the partial meniscectomy group versus $4092 in the nonoperative group 84. The highest cost patients in this group were the ones who started in the nonoperative group and went on to total knee arthroplasty ($32,197) 84.…”

Section: Economic Burden Of Injurymentioning

confidence: 98%

“…In an analysis of 50 patients who underwent partial meniscectomy or nonoperative management, 24-month direct costs were comparable at $4488 in the partial meniscectomy group versus $4092 in the nonoperative group 84. The highest cost patients in this group were the ones who started in the nonoperative group and went on to total knee arthroplasty ($32,197) 84. An insurance database study had contradicting results showing much lower cost of physical therapy ($411 vs. $3843) 85.…”

Section: Economic Burden Of Injurymentioning

confidence: 99%

See 1 more Smart Citation

The Epidemiology of Meniscus Injury

Adams

Houston

Cameron

2021

Sports Medicine and Arthroscopy Review

View full text Add to dashboard Cite

Meniscus surgery is one of the most commonly performed orthopedic procedures worldwide. Modifiable risk factors for meniscus injury include body mass index, participation in athletics and occupation. Nonmodifiable risk factors include age, sex, lower extremity alignment, discoid meniscus, ligamentous laxity, and biconcave tibial plateau. Conditions commonly associated with meniscal injury are osteoarthritis, anterior cruciate ligament injury, and tibial plateau fractures. Tear type and location vary by patient age and functional status. Surgical management of meniscus injury is typically cost-effective in terms of quality-adjusted life years. The purpose of this review is to provide an overview of meniscal injury epidemiology by summarizing tear types and locations, associated conditions, and factors that increase the risk for meniscal injury. The economic burden of meniscus injury and strategies to prevent injury to the meniscus are also reviewed.

show abstract

Direct treatment cost outcomes among patients with medial meniscus deficiency: results from a 24-month surveillance study

Cited by 5 publications

References 32 publications

Health-economic evaluation of meniscus tear treatments: a systematic review

Health-economic evaluation of meniscus tear treatments: a systematic review

Cost-Effectiveness Analysis of a Medial Meniscus Replacement Prosthesis for the Treatment of Patients with Medial Compartment Pain in the United Kingdom

The Epidemiology of Meniscus Injury

Contact Info

Product

Resources

About