Soft tissue considerations may also delay operative fixation and/or contraindicate ORIF altogether.
Delayed operative delivery was indicated as one of the avoidable factors.
When comparing TKA without delay to waiting with non-operative bridge, TKA without delay produced greater utility at a lower cost to society.
The decision tree consists of three principal treatment arms, or strategies: TKA without delay, delayed TKA with non-operative bridge treatment and delayed TKA with no bridge treatment.
As it is unlikely that patients waiting for TKA would not receive non-operative treatment, TKA without delay may be an overall cost-saving health care delivery strategy.
When comparing TKA without delay to waiting with a non-operative bridge, TKA without delay produced greater utility for the patient at a lower cost to society, therefore, dominating the waiting with non-operative bridge strategy for the treatment of knee osteoarthritis.
METHODS: A Markov decision model was constructed for a cost-utility analysis of three treatment strategies for end-stage knee osteoarthritis: 1) TKA without delay, 2) a waiting period with no non-operative treatment and 3) a non-operative treatment bridge during that waiting period in a cohort of 60 year-old patients.
A Markov decision model was constructed for a cost-utility analysis of three treatment strategies for end-stage knee osteoarthritis: 1) TKA without delay, 2) a waiting period with no non-operative treatment and 3) a non-operative treatment bridge during that waiting period in a cohort of 60 year-old patients.
TKA without delay is cost saving when a non-operative bridge is used during the waiting period.
Similarly, if the cost of the non-operative bridge falls below $294/month, it becomes less costly than TKA without delay, but TKA without delay is still the preferred cost effective strategy.
The average cost was $1,660 higher for TKA without delay than wait-time with no bridge, but $1,810 less than wait-time with non-operative bridge.
