The Economics of Minimally Invasive Total Knee Surgery

Coon, Thomas M.; Tria, Alfred J.; Lavernia, Carlos J.; Randall, Leon

doi:10.1053/j.sart.2005.10.016

Cited by 13 publications

(7 citation statements)

References 3 publications

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“…8 Thus, despite excellent Knee Society scores, patients with TKA may experience serious functional limitations after the procedure. 11 We recognize that the lack of a thigh tourniquet in the present series contributed to earlier recovery from TKA. 3,20 The benefits of MIS surgery extend beyond patient satisfaction and improved early outcomes; the efficiency and economic rationale of MIS TKA have also been validated.…”

Section: Discussionmentioning

confidence: 63%

Primary Total Knee Arthroplasty Performed With a Minimally Invasive Surgery Subvastus Approach

Bal¹,

Greenberg²,

Lowe³

et al. 2007

Techniques in Knee Surgery

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| ABSTRACTThe subvastus surgical approach to total knee arthroplasty preserves the insertion of the vastus medialis tendon on the patella, thereby resulting in superior functional outcomes in the short term. This surgical approach was adapted to perform a consecutive series of primary uncemented total knees, without a thigh tourniquet, using a short-length incision. The outcomes are reported herein.One hundred fifteen primary total knees were performed using instrumentation optimized for minimally invasive surgery. Porous implants, including a monoblock trabecular metal tibial component, were implanted in each knee. Mean incision length was 4 in. Mean patient age was 67 years, and mean patient weight was 188 lb. No tourniquet was used in any knee, and a standard rehabilitation protocol was used with full weight-bearing after the operation.At a minimum follow-up of 12 months after surgery, 1 knee had undergone repeat surgery to revise a loose patella component. This complication was most likely related to an undisplaced patella fracture that occurred when the patient fell in the postoperative period. Another patient developed a deep venous thrombosis. No other complications occurred, and radiographs demonstrated satisfactory component positioning. Mean knee arc of motion at 4 weeks after surgery was 114 degrees, and most patients did not require formal physical therapy after a month after the operation.Because no muscle or tendon detachment is involved, the subvastus approach is ideally suited for minimally invasive surgery, especially if a thigh tourniquet is not used. The present series illustrates the safety, consistency, and reliability of this technique in a consecutive series of patients with knee arthritis. Faster patient recovery and greater patient satisfaction were achieved, without increased complications.

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Section: Discussionmentioning

confidence: 63%

Primary Total Knee Arthroplasty Performed With a Minimally Invasive Surgery Subvastus Approach

Bal¹,

Greenberg²,

Lowe³

et al. 2007

Techniques in Knee Surgery

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“…There is little reported in the literature regarding the cost benefits of MIS TKA. Coon et al [7] reported a charge reduction of $8600 per patient using MIS, but as noted, the sources of this reduction were not specified and simply may have been more efficient use of two operating suites. We therefore asked whether MIS TKAs are associated with decreased inpatient charges and hospital costs compared with traditional TKAs.…”

Section: Discussionmentioning

confidence: 99%

“…However, other factors, such as increased operative times, altered regimens of physical therapy, variations in the use of radiology services, and concerns that improper MIS component position may lead to early revision, may prevent the putative clinical benefits from translating into decreases in hospital costs or patient charges. Coon et al [7] were among the few authors to detail decreased costs associated with MIS TKA, but several methodologic limitations in their study limit drawing firm conclusions and call into question the magnitude of the reported cost savings. First, they reported a charge reduction of $8600 per patient using MIS; however, the sources of this reduction were not specified and simply may have been more efficient use of two operating suites.…”

Section: Introductionmentioning

confidence: 97%

Is Minimally Invasive Total Knee Arthroplasty Associated with Lower Costs Than Traditional TKA?

King

Manner

Stamper

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Studies of minimally invasive surgery (MIS) approaches to TKA have shown decreased postoperative pain, earlier return to function, and shorter lengths of stay in the hospital. However, it is unclear whether these differences translate into decreased costs or charges associated with care. Questions/purposes We asked whether a minimally invasive approach to TKA is associated with lower inpatient charges and direct inpatient costs than the traditional approach. Patients and MethodsWe retrospectively reviewed one high-volume arthroplasty surgeon's first 100 minimally invasive TKAs with the last 50 traditional TKAs with respect to all perioperative inpatient medical and billing records. Total charges minus implants (which were excluded across groups), total direct costs, and individual cost centers were analyzed.

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“…March et al 25 Rasanen et al 32 Keating et al 30 Bozic et al 26 Honkanen et al 12 SooHoo et al 20 Slover et al 21 Coon et al 42 Gandjour et al 13 McBryde et al 36 Duwelius et al 6 Chang et al 23 Rorabeck et al 18 Clinkscales and Peterson 40 Rissanen et al 19 Lorenze et al 37 Givon et al 17 Gartsman et al 39 Kumar and Parker McKenzie et al 22 Briggs et al 31 Fielden et al 15 Meyer et al 8 38 Honkanen et al 24 Karuppiah et al 14 Papakonstantinou et al 35 Marinelli et al…”

Section: Disclosurementioning

confidence: 99%

Socioeconomic value of orthopedic devices: evidence and methodological challenges

Sorenson¹,

Drummond²

2012

ORR

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Abstract:With continued technological advances in orthopedic devices and increasingly limited health care resources, greater attention will be placed on substantiating the socioeconomic value of these devices. Therefore, this study focused on a systematic review of available economic evaluations of selected orthopedic devices (n = 33 studies) to assess their impact on different clinical and economic outcomes. The existing evidence suggests that they have important benefits to patients, including reduced risk of fractures, increased mobility and functioning, and enhanced quality of life, and do so cost effectively or with cost savings. However, we have identified several methodological obstacles to sufficient ascertainment of value, such as a lack of robust information on health economic outcomes and long-term evidence. We also identify areas where additional research is needed to assess more fully the value of orthopedic devices.

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The Economics of Minimally Invasive Total Knee Surgery

Cited by 13 publications

References 3 publications

Primary Total Knee Arthroplasty Performed With a Minimally Invasive Surgery Subvastus Approach

Primary Total Knee Arthroplasty Performed With a Minimally Invasive Surgery Subvastus Approach

Is Minimally Invasive Total Knee Arthroplasty Associated with Lower Costs Than Traditional TKA?

Socioeconomic value of orthopedic devices: evidence and methodological challenges

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