Costs of staged versus simultaneous bilateral total knee arthroplasty: a population-based study of the Taiwanese National Health Insurance Database

Hsyien-Chia Wen,Hsiao-Li Ma,Aaron Lin,En Chao,Chen Yang ,Tzu-Chuan Lu

doi:10.1186/preaccept-1517818052107297

Abstract

Bilateral total knee arthroplasty (TKA) is required for many patients. There are few studies comparing the overall costs of staged and simultaneous bilateral TKA. The Taiwan National Health Insurance Research Database (NHIRD) was searched, and the total medical costs of 452 patients who received simultaneous bilateral TKAs were compared with those of 690 who received staged bilateral TKAs. All categories of medical costs were lower in the simultaneous TKA group, with the exception of therapeutic procedure fees which were higher in the simultaneous bilateral TKA group. The 10-year prosthesis survival rates for simultaneous and staged bilateral TKA were 90.9% and 87.5% (p > 0.05), respectively. These results indicate that simultaneous bilateral TKA is more cost effective than staged bilateral TKA. Prosthesis survival is not affected by the choice for staged or simultaneous bilateral TKA.

Highlights

Bilateral total knee arthroplasty (TKA) is required for many patients
Baseline characteristics A total of 1,142 patients who received bilateral TKAs were included in the data analysis (Figure 1), consisting of 452 who received simultaneous bilateral TKAs and 690 who received staged bilateral TKAs
The entire length of hospital stay was longer in the staged bilateral TKA group as compared to that of the simultaneous bilateral TKA group (15.0 [12.0, 18.0] days vs. 12.0 [9.0, 15.0] days, respectively; p < 0.001)

Summary

Introduction

There are few studies comparing the overall costs of staged and simultaneous bilateral TKA. Total knee arthroplasty (TKA) is widely believed to be the best choice for the treatment of end-stage of knee arthropathy, and the procedure can significantly improve the quality of life for these patients. Multiple diseases such as osteoarthritis (OA), rheumatoid arthritis (RA), and hemophilia can result in severe bilateral knee destruction, and patients frequently require bilateral TKA [1]. To the best of our knowledge, there is no other database like the Taiwan National Health Insurance NHIRD that complied such long-term complete population data [15]

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Discussion

Conclusion