Cost-Effectiveness Analysis of Periacetabular Osteotomy

Sharifi, Emile; Sharifi, Husham; Morshed, Saam; Bozic, Kevin; Diab, Mohammad
July 2008
Journal of Bone & Joint Surgery, American Volume;Jul2008, Vol. 90-A Issue 7, p1447
Academic Journal
Background: A lack of tong-term outcomes data following periacetabular osteotomy makes it difficult for surgeons to recommend the most appropriate procedure to young patients who might be candidates for ajoint-preserving procedure. In this study, we compared the cost-effectiveness of periacetabular osteotomy with total hip arthroplasty in terms of cost per quality-adjusted life year for the young adult. Methods: A decision model was constructed for a cost-utility analysis of periacetabular osteotomy compared with total hip arthroplasty. Outcome probabilities and effectiveness were derived from the literature. Effectiveness was expressed in quality-adjusted life years gained. Cost data were compiled and verified from our institution. Costs and utilities were discounted in accord with the United States Panel on Cost-Effectiveness in Health and Medicine. Principal outcome measures were average incremental costs, incremental effectiveness, incremental quality-adjusted life years, and net health benefits. Multivariate sensitivity analysis was used to assess the contribution of included variables in the model's outcomes. Results: For Tönnis grade-1 coxarthrosis, periacetabular osteotomy dominates with an average incremental cost-effectiveness of $7856 per quality-adjusted life year and an average incremental effectiveness of 0.15. For Tönnis grade-2 coxarthrosis, periacetabular osteotomy is, on the average, more cost-effective than total hip arthroplasty with an incremental cost-effectiveness of $824 per quality-adjusted life year, but it is less effective than total hip arthroplasty, on the average, with an incremental effectiveness of-1.4 quality-adjusted life years. Periacetabular osteotomy becomes more cost-effective at a longevity of 5.5 years for Tönnis grade-1 coxarthrosis and 18.25 years for Tönnis grade-2 coxarthrosis. In Tönnis grade-3 coxarthrosis, total hip replacement becomes the dominant treatment strategy. Conclusions: Periacetabular osteotomy is, on the average, more cost-effective in Tönnis grade-1 and grade-2 coxarthrosis, while it is both more costly and less effective in Tönnis grade-3 coxarthrosis. These findings can inform clinical decision- making in the absence of long-term data. On the basis of this model, periacetabular osteotomy is preferable to total hip arthroplasty in Tönnis grade-1 and grade-2 coxarthrosis when the patient is sufficiently young and when functionality in sports is important.


Related Articles

  • Emergency Brake Response Time After First Metatarsal Osteotomy. Holt, G.; Kay, M.; McGrory, R.; Kumar, C. S. // Journal of Bone & Joint Surgery, American Volume;Aug2008, Vol. 90-A Issue 8, p1660 

    Background: There is sparse information upon which to recommend a return to activity after foot surgery. The purpose of this study was to determine whether six weeks is sufficient time for the emergency brake response time to return to preoperative levels after a first metatarsal osteotomy for...

  • Long-Term Follow-up of Radial Shortening Osteotomy for Kienböck Disease. Watanabe, Tadayoshi; Takahara, Masatoshi; Tsuchida, Hiroyuki; Yamahara, Shinichi; Kikuchi, Noriaki; Ogino, Toshihiko // Journal of Bone & Joint Surgery, American Volume;Aug2008, Vol. 90-A Issue 8, p1705 

    Background: Three previous studies have investigated the long-term outcome of radial osteotomy in the treatment of Kienböck disease. However, none used patient-based assessment. The purpose of this study was to investigate the long-term clinical and radiographic outcomes of this osteotomy,...

  • Intermediate-Term Results of the Ludloff Osteotomy in One Hundred and Eleven Feet. Trnka, H.-J.; Hofstaetter, S. G.; Easley, M. E. // Journal of Bone & Joint Surgery, American Volume;Mar2009 Supplement, Vol. 91-A, p156 

    BACKGROUND: The modified Ludloff proximal first metatarsal osteotomy is indicated for the surgical correction of moderate-to-severe hallux valgus deformity associated with metatarsus primus varus. We report the intermediate-term results of this procedure. METHODS: Ninety-nine patients (111 feet)...

  • 대퇴골두 골절에서 시행한 대전자 Flip 절골술의 유용성. 이경재; 민병우; 사공협; 임영재; 민경근; 전종혁 // Journal of the Korean Orthopaedic Association;Jun2013, Vol. 48 Issue 3, p205 

    Purpose: The purpose of this study is to evaluate the clinical and radiological results of the trochanteric flip osteotomy in cases of femoral head fractures. Materials and Methods: Between May 2000 and January 2012, we evaluated 14 cases of femoral head fractures treated by trochanteric flip...

  • Informal care costs have "strong impact" on economic analyses.  // PharmacoEconomics & Outcomes News;Nov2014, Vol. 715 Issue 1, p21 

    The article discusses research being done on the effects of informal caregiving costs on cost-effectiveness outcomes, referencing the study "Does Including Informal Care in Economic Evaluations Matter? A Systematic Review of Inclusion and Impact of Informal Care in Cost-Effectiveness Studies" by...

  • PERSPECTIVE. Miller, Stuart D. // Orthopedics Today;Jul2011, Vol. 31 Issue 7, p52 

    The author presents his views on a study by Sandro Giannini and colleagues which demonstrated the benefits of simple, effective, rapid, inexpensive (SERI) distal metatarsal osteotomy technique for patients with hallux valgus.

  • ART cost for kids in South Africa.  // PharmacoEconomics & Outcomes News;10/13/2012, Issue 664, p7 

    The article discusses research on the cost and outcomes of paediatric antiretroviral treatment in South Africa, referencing a study by G. Meyer-Rat and colleagues, published in the September 25, 2012 issue of "AIDS."

  • Combined Intra-Articular and Varus Opening Wedge Osteotomy for Lateral Depression and Valgus Malunion of the Proximal Part of the Tibia. Kerkhoffs, Gino M. M. J.; Rademakers, Maarten V.; Altena, Mark; Marti, René K. // Journal of Bone & Joint Surgery, American Volume;Mar2009 Supplement, Vol. 91-A, p101 

    BACKGROUND: Reconstructive surgical measures for treatment of posttraumatic deformities of the lateral tibial plateau are seldom reported on in the literature. We report the long-term follow-up results of a consecutive series of reconstructive osteotomies performed to treat depression and valgus...

  • Rehabilitation After Hallux Valgus Surgery: Importance of Physical Therapy to Restore Weight Bearing of the First Ray During the Stance Phase.  // Physical Therapy;Sep2009, Vol. 89 Issue 9, p934 

    Background. Operative treatment of people with hallux valgus can yield favorable clinical and radiographic results, However, plantar pressure analysis has demonstrated that physiologic gait patterns are not restored after hallux valgus surgery. Objective. The purpose of this study was to...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics