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Table 1 Economic evaluation summary evidence table

From: Cost-effectiveness of surgical interventions for the management of osteoarthritis: a systematic review of the literature

No. Author & year Country Intervention (s) Comparator (s) Study design Economic study type Perspective Study population Measure of effectiveness Cost types / Currency / Price year Discount rates
1. Bedair et al, [18] USA Total knee arthroplasty (TKA) Non-operative treatment Markov model CBA Societal Severe unilateral knee OA Cost saving approximately 3.5 years after surgery Direct and indirect costs / US dollar / 2012 3% for costs and effects
2. Bozic et al, [29] USA Metal-on-metal hip resurfacing arthroplasty (MoM-HRA) Total hip arthroplasty (THA) Markov model CUA Healthcare system Patients with advanced hip OA QALYs Direct costs / US dollar / price year not clearly stated (2008/2009) 5% for costs and effects
3. Di Tanna et al, [39] Italy Cementless fixation technique for THA Hybrid fixation technique for THA Markov model CEA Healthcare provider Patients with hip OA undergoing THA "revision-free" life year Only prosthesis, surgical and revision costs / Euro / price year not stated 3.5% for costs and effects
4. Heintzbergen et al, [37] Canada MoM-HRA Conventional THA Markov model CUA Healthcare system Patients with hip OA undergoing hip arthroplasty QALYs Direct costs / Canadian dollar / 2011 3% for costs and effects
5. Higashi et al, [35] Australia Total replacement of hips and knees ‘Doing nothing’ (non-surgical therapies without joint replacements) Discrete event simulation model CUA Healthcare system 68,908 with hip OA and 100,657 with knee OA DALYs (disability-adjusted life-years) Direct costs / Australian dollar / 2003 3% for costs and effects
6. Koskinen et al, [21] Finland Unicondylar arthroplasty (UKA) TKA Register-based analysis CEA Not mentioned Knee OA patients undergoing either UKA or TKA or both "revision-free" life year Only prosthesis costs (3 different UKA implants) / Euro / 2003 Nil
7. Li et al, [22] Germany KineSpring Knee Implant System No treatment, conventional treatments or other surgical interventions for knee OA Not reported CUA Not mentioned Mild-to-moderate knee OA patients (not eligible for TKA /UKA) QALYs Direct and indirect costs (no details given) / Euro / 2012 Nil
8. Losina et al, [36] USA TKA done in low, medium & high volume hospitals No TKA performed Markov model CUA Societal Patients with end-stage knee OA for TKA QALYs Direct and indirect costs / US dollar / 2006 3% for costs and effects
9. Mota, [38] Italy Early primary THA 1. Non-surgical then primary THA
2. Non-surgical with NSAIDs
Markov model CUA Healthcare provider Patients with hip OA undergoing hip arthroplasty QALYs Direct costs / Euro / 2010 3% for costs and effects
10. Pennington et al, [41] UK / England Cementless and hybrid prosthesis for THA Cemented prosthesis for THA Markov model CUA Healthcare system OA patients aged 55 to 84 undergoing THA QALYs Direct costs only / British pound sterling / 2010-2011 3.5% for costs and effects
11. Räsänen et al, [28] Finland 1. Primary THA
2. Secondary / revision THA
3. Primary TKA
Non-operative intervention Cohort-based study CUA Healthcare provider Cohort of patients from 30 medical entities in Finland QALYs Direct hospital costs only / Euro / price year not stated 5% for effects (QALY) only
12. Ruiz et al, [31] USA TKA Non-operative treatment Markov model CUA Societal Adults aged 40 years old and older undergoing TKA for knee OA in the USA in 2009 QALYs Direct and indirect costs / US dollar / 2009 3% for costs and effects
13. SooHoo et al, [25] USA UKA TKA Decision tree CUA Societal Unicompart-mental knee OA patients QALYs Direct costs only / US dollar / 1998 3% for costs and effects
14. Suter et al, [26] USA “innovative” TKA implants (highly crossed-linked polyethylene or other innovative biomaterials) “standard” implants (an ultra-high molecular weight all polyethylene tibial component) Markov analysis based on Osteoarthri-tis Policy (OAPol) Model CUA Societal Adults with symptomatic end stage knee OA needing TKA QALYs Direct costs only / US dollar / 2010 3% for costs and effects
15. Waimann et al, [32] USA TKA Hypothetical nonsurgery strategy Cohort-based study CEA Societal 212 patients with knee OA who under-went TKR. Improvement in WOMAC score Direct and indirect costs / US dollar / 2007 Nil
16. Xie et al, [27] Canada & Singapore TKA UKA Cohort-based study (hospital in Singapore) CUA Societal 431 TKR patients and 102 UKA patients QALYs Direct costs only / US dollar / 2008 Nil
17. Konopka et al, [33] USA HTO and UKA TKA Markov model CUA Societal Patients with knee OA requiring surgery QALYs Direct and indirect costs / US dollar / 2012 3% for costs and effects
18. Marsh et al, [19] Canada Arthroscopic surgery in addition to non-operative treatments Non-operative treatments alone (optimised physical and medical therapy) Alongside RCT CEA and CUA Healthcare and societal Patients with knee OA WOMAC Index
QALYs
Direct and indirect costs / Canadian dollar / 2014 Nil
19. Mather et al, [20] USA Primary TKA without delay Delayed TKA (with and without non-operative bridge treatment) Markov model CUA Healthcare and societal End-stage knee OA QALYs Direct and indirect costs / US dollar / 2009 3%
20. Peersman et al, [34] Belgium UKA TKA Markov model CUA Healthcare Patients with unicondylar knee OA QALYs Direct costs / Euro / 2014 1.5% and 3%
21. Pennington et al, [23] UK Different brands within types of hips prosthesis (cemented, cementless and hybrid) - Markov model CUA Not mentioned Patients with hip OA requiring primary THA QALYs Direct costs / British pounds sterling / 2010/2011 3.5%
22. Pulikottil-Jacob et al, [40] UK Combinations of components in hip prosthesis for THA, including the type of fixation and bearing surfaces - Markov model CUA NHS and Personal Social Services Patients undergoing THA for hip OA QALYs Direct costs / British pound sterling / 2012 3.5%
23. Stan et al, [24] Romania Unilateral TKA and TKA following HTO Rehabilitation care Alongside clinical trial CUA Not mentioned Patients with knee OA QALYs Direct costs / Euro / year not mentioned 3% (outcome only)