PMID- 38226709
OWN - NLM
STAT- MEDLINE
DCOM- 20240117
LR  - 20240117
IS  - 1433-7347 (Electronic)
IS  - 0942-2056 (Linking)
VI  - 32
IP  - 1
DP  - 2024 Jan
TI  - Economic evaluation of high tibial osteotomy: Closing wedge is more 
      cost-effective than open wedge technique when analysing the KOOS-12 improvement.
PG  - 95-102
LID - 10.1002/ksa.12026 [doi]
AB  - PURPOSE: The purpose of this study was to compare the cost-effectiveness of two 
      techniques for performing a knee valgus osteotomy: opening wedge high tibial 
      osteotomy (OW-HTO) vs closing wedge high tibial osteotomy (CW-HTO). METHODS: In 
      this economic evaluation study, a cost-effectiveness analysis from the 
      perspective of the Spanish public healthcare system was performed, comparing 
      OW-HTO with CW-HTO. All patients with medial knee osteoarthritis who underwent 
      one of these procedures between 2018 and 2020 in our institution were included. 
      The cost analysis included operating room, implant, graft and hospital admission 
      costs. Functional outcomes (KOOS-12, Tegner activity scale, pain and 
      satisfaction) and radiological outcomes (hip-knee-ankle angle, medial proximal 
      tibial angle, tibial slope and patellar height) were analysed. The 
      cost-effectiveness ratio was obtained by calculating the cost of improving the 
      minimal clinically important difference (MCID) of KOOS-12 for each procedure. All 
      costs are expressed in 2020 euros. RESULTS: Fifty-one patients met the inclusion 
      criteria (27 OW-HTO and 24 CW-HTO). Good to excellent functional outcomes, 
      significant pain reduction (>6 points) and high patient satisfaction (>9/10) were 
      observed in both groups. Both techniques yielded excellent radiological outcomes. 
      N.s. differences in functional or radiological outcomes improvements between both 
      procedures were found. However, the OW-HTO group presented a higher total cost 
      than the CW-HTO group (4612.1 +/- 765.6euro vs. 1827.1 +/- 701.9euro; p < 0.001). The 
      cost-effectiveness ratio was 818.1 +/- 46.8 euro/MCID for the CW-HTO procedure and 
      2414.3 +/- 115.2 euro/MCID for the OW-HTO procedure (p = 0.025). CONCLUSION: The 
      CW-HTO procedure presented a cost-effectiveness ratio almost three times lower 
      than the OW-HTO procedure. Both techniques allowed to achieve of good to 
      excellent functional outcomes, significant pain reduction and high patient 
      satisfaction while correcting the varus limb malalignment and the metaphyseal 
      tibial varus in patients with medial compartment osteoarthritis. LEVEL OF 
      EVIDENCE: Level III; economic study.
CI  - (c) 2024 European Society of Sports Traumatology, Knee Surgery and Arthroscopy.
FAU - Ferrer-Rivero, Robert
AU  - Ferrer-Rivero R
AUID- ORCID: 0000-0002-6653-5249
AD  - Department of Orthopaedic Surgery, Bellvitge University Hospital, Barcelona 
      University, Hospitalet de Llobregat, Barcelona, Spain.
FAU - Pujol, Oriol
AU  - Pujol O
AUID- ORCID: 0000-0003-4760-2730
AD  - Department of Orthopaedic Surgery, Vall d'Hebron University Hospital, Universitat 
      Autonoma de Barcelona, Barcelona, Spain.
FAU - Ferrer-Rivero, Josep
AU  - Ferrer-Rivero J
AUID- ORCID: 0009-0000-8643-8051
AD  - Department of Orthopaedic Surgery, Germans Trias i Pujol University Hospital, 
      Universitat Autonoma de Barcelona, Badalona, Spain.
FAU - De Maria Prieto, Jose Manuel
AU  - De Maria Prieto JM
AUID- ORCID: 0000-0002-1861-9245
AD  - Department of Orthopaedic Surgery, Bellvitge University Hospital, Barcelona 
      University, Hospitalet de Llobregat, Barcelona, Spain.
FAU - Oliver, Gabriel
AU  - Oliver G
AUID- ORCID: 0000-0002-0019-7144
AD  - Department of Orthopaedic Surgery, Bellvitge University Hospital, Barcelona 
      University, Hospitalet de Llobregat, Barcelona, Spain.
LA  - eng
GR  - None/
PT  - Journal Article
DEP - 20240103
PL  - Germany
TA  - Knee Surg Sports Traumatol Arthrosc
JT  - Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
JID - 9314730
SB  - IM
MH  - Humans
MH  - Cost-Benefit Analysis
MH  - *Cost-Effectiveness Analysis
MH  - Knee Joint/surgery
MH  - *Osteoarthritis, Knee/surgery
MH  - Tibia/surgery
MH  - Osteotomy/methods
MH  - Pain
MH  - Treatment Outcome
OTO - NOTNLM
OT  - closing wedge high tibial osteotomy
OT  - cost-effectiveness
OT  - knee
OT  - opening wedge high tibial osteotomy
OT  - osteotomy
OT  - varus
EDAT- 2024/01/16 13:42
MHDA- 2024/01/17 06:42
CRDT- 2024/01/16 08:32
PHST- 2023/11/11 00:00 [received]
PHST- 2023/12/01 00:00 [accepted]
PHST- 2024/01/17 06:42 [medline]
PHST- 2024/01/16 13:42 [pubmed]
PHST- 2024/01/16 08:32 [entrez]
AID - 10.1002/ksa.12026 [doi]
PST - ppublish
SO  - Knee Surg Sports Traumatol Arthrosc. 2024 Jan;32(1):95-102. doi: 
      10.1002/ksa.12026. Epub 2024 Jan 3.