The Cost Effectiveness of Unicompartmental versus Total Knee Arthroplasty

Abstract

Purpose: This study examines the potential cost savings for the health system and the community in a broadly accessible model through the increased utilization of UKA using robotic arm-assisted UKA vs conventional TKA. Methods: We retrospectively reviewed 240 patients where the first 120 consecutive robotic arm-assisted UKA performed during this period were matched to 120 conventional TKAs. Clinical data from the medical records and costs for procedure for each component were collected. Bivariate analyses were performed on the data to determine if there were statistically significant differences by surgery type in clinical outcomes and financial costs. Results: There was a significantly lower cost incurred for robotic arm-assisted UKA vs TKA with an average saving of AU$7179 per case. The operating time (86.0 min vs 75.9 min; p=0.004) was significantly higher for UKA but the length of stay was significantly lower (1.8 vs 4.8 days; p<0.001). There was a significant difference in the use of opioids between UKA compared to TKA (125.0 morphine equivalent (ME) vs 522.1 ME, p<0.001). Conclusion: This study demonstrated that the use of robotic arm-assisted UKA rather than TKA in suitably indicated patients may realize significant cost savings. Received: 26 January 2022 Accepted after revision: 18 October 2022 Accepted Manuscript online: 25 October 2022 © . Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany