Cost-Effectiveness of Unicompartmental Knee Arthroplasty, High Tibial Osteotomy, and KineSpring® Knee Implant System for Unicompartmental Osteoarthritis of the Knee
Bibliographic record
Abstract
Osteoarthritis (OA) of the knee is a condition that causes pain and disability. Numerous non-surgical and surgical interventions are available for individuals with OA that result in good pain relief and return of function. The purpose of this economic analysis was to determine the cost-effectiveness of high tibial osteotomy (HTO), unicompartmental knee arthroplasty (UKA) and the KineSpring® Knee Implant System in the treatment of unicompartmental OA of the knee 10 years post-surgery, considering the costs of revisions, conversions, removals, and complications. Estimates of costs and rates of revision, conversion, removal, and complications related to UKA and HTO were obtained from the literature. Internal reports on the KineSpring System were used for calculations on the KineSpring System. The cost-effectiveness of UKA, HTO and the KineSpring System in terms of QALY gained compared to patients without treatment yielded gains of approximately $5150/QALY, $6754/QALY, and $7010/QALY, respectively. Using the accepted standard willingness-to-pay threshold of $50,000 US/QALY gained, the UKA, HTO, and the KineSpring System are economically favorable. Our analysis demonstrates that the KineSpring System, despite a greater initial cost in surgery, has significantly smaller conversion and complication costs compared to UKA and HTO. The 10 years overall expected cost for the KineSpring System ($12,559) is significantly less compared with that of UKA ($17,570) and HTO ($22,825). Future economic analyses regarding this topic should also consider the cost-effectiveness of these procedures on younger, more active individuals who are still working and should take into account productivity loss.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.009 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".