Evaluation of Appropriateness of the Reimbursement Criteria of Korean Health Insurance Review and Assessment Service for Total Knee Arthroplasty

Kim, Dong-Hong; Jeong, Soo-Young; Yang, Jae Hyuk; Choi, Choong-Hyeok

doi:10.4055/cios21214

Cited by 2 publications

(1 citation statement)

References 22 publications

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“…Many previous studies indicate older age itself as a risk factor for TKA conversion after HTO [ 20 , 21 ]. However, when contemplating that the clinical outcome results are similar between the two groups, the difference in conversion to TKA may be due to the reimbursement criteria of the national health insurance system which allows patients over 60 years to undergo TKA [ 22 ]. The results of the present study and the results of previous studies show that when other factors are accounted for, the mid-term results are similar between younger are older age groups [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical and radiological results of high tibial of osteotomy over the age of 65 are comparable to that of under 55 at minimum 2-year follow-up: a propensity score matched analysis

Park,

Kim,

Cho

et al. 2024

Knee Surg & Relat Res

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Purpose The results of medial open-wedge high tibial osteotomy (MOWHTO) according to age is inconclusive. This study aimed to compare the clinical outcomes and failure of MOWHTO in patients < 55 years and > 65 years. Methods Consecutive patients who underwent MOWHTO from July 2009 to August 2020 were retrospectively analyzed. 205 patients were considered for analysis. A 1-to-1 propensity score matched analysis to assess clinical outcomes scores including International Knee Documentation Committee (IKDC) subjective score and Lysholm score, radiologic outcomes, complication, and Total Knee Arthroplasty (TKA) conversion between patients > 65 years and patients < 55 years was performed. Radiologic outcomes included Hip-Knee-Ankle (HKA) angle, Weight Bearing Line ratio (WBLR), posterior tibial slope (PTS), and Insall-Salvati (IS) ratio before and after surgery. Results The follow-up period was 50.4 months in patients > 65 years and 55.3 months in patients < 55 years. There was no significant difference in the preoperative and postoperative HKA angle, WBLR, PTS, IS ratio, IKDC score and Lysholm score between the two groups. The arthroscopic evaluation of cartilage did not show any statistically significant differences between the two groups. Regarding Minimal clinically important differences (MCID), in the 26% of the older group exceeded MCID of IKDC score; 45% of the older group exceeded MCID of Lysholm score. In the younger group, 24% exceeded MCID of IKDC score and 35% exceeded MCID of Lysholm score. In older group, there were 7 (11.3%) cases of TKA conversion while no TKA conversion was recorded in the younger group. (P = 0.007) The average time to TKA conversion was 67 months. (42 months to 90 months) Kaplan–Meier analysis revealed that the survival rate was 95.2% at 4 years in the older group. Conclusion Similar clinical results were obtained in patients over 65 years of age that were eligible for MOWHTO at minimum 2-year follow-up as in patients under 55 years of age. MOWHTO may be a viable option in older patients if proper indications are met. However, the risk of TKA conversion must be considered preoperatively and discussed with patients. Study Design: Cohort study; Level of evidence, 3.

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