Comparing the Cost of Total Knee Replacements Around the WorldTotal knee replacement (TKR) is the most common joint replacement surgery now. More TKRs are done than even total hip replacements. As the number of TKRs goes up, so does the number of revision surgeries. The rising medical costs for two or more operations are a concern. The authors of this article compare costs of primary and revision TKRs from different health care systems around the world.
The results of this study show that the cost of TKR and revision TKR is much less than heart surgery or organ transplantation. Not only that, but the costs associated with TKR have gone down over the years. Better patient management has led to shorter hospital stays and faster recovery. Patient quality of life has improved greatly with TKR.
Revision TKRs cost more and are more difficult to do. There are more complications with revision surgery but pain relief and improved function make it worth it to the patients. Comparing costs of TKRs and revision TKRs isn't easy because data collected varies from country to country.
Any treatment that costs less than $20,000 is considered cost effective. All countries surveyed reported the cost of primary and revision TKRs as less than this. New Zealand was the lowest at $7101 for a primary TKR compared to the United States at $15,476. Revision TKR costs between $10,000 and $15,000 in most countries.
The authors say as the adult population ages, more and more TKR surgeries are going to be done. There may be some ways to reduce the number and cost of revision surgery. First, a registry to collect patient data may help point out patterns in patient selection or treatment that could make a difference. Improved implants should also help. And many studies have shown that high volume surgery centers have the best results.
Alexander W. R. Burns, MBBS, FRACS, et al. Cost Effectiveness of Revision Total Knee Arthroplasty. In Clinical Orthopaedics and Related Research. May 2006. No. 446. Pp. 29-33.
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