Does UKA yield health economic advantages in comparison with TKA?

Although Total Knee Arthroplasty (TKA) generally achieves excellent outcomes, patients may experience impaired functional activity and residual pain postoperatively. Compared with TKA, Unicondylar Knee Arthroplasty (UKA) may achieve a more normal gait, decreased perioperative trauma, and faster rehabilitation. Consequently, UKA may be a valuable alternative to TKA. However, there is general consensus in the literature that UKA has a higher revision rate than TKA. AMR Advanced Medical Research staff participated in a research project that was undertaken to assess the cost-effectiveness of UKA versus TKA, taking a Belgian payer's perspective.

The research team developped a state-transition Markov model that included the possibility of two revision procedures. Model estimates were obtained through literature review.

The Markov model demonstrated that UKA yielded clear advantages in terms of costs. Cost advantages were attributable to the comparably shorter length of stay for UKA, lower costs of materials, and a smaller proportion of patients requiring stationary rehabilitation and ambulatory physiotherapy. From an economic point of view, the immediate reduction of costs in all patients receiving UKA offsets any higher costs due to an increased revision rate for UKA.  

Peersman G, Jak W, Vandenlangenbergh T, Jans C, Cartier P, Fennema P. Cost-effectiveness of unicondylar versus total knee arthroplasty: a Markov model analysis. Knee; 21 Suppl 1: S37-42.