Imperial College London
Portrait Picture

MrAlexLiddle

Faculty of Medicine, Department of Surgery & Cancer

Clinical Senior Lecturer in Orthopaedics
 
 
 
//

Contact

 

a.liddle Website

 
 
//

Assistant

 

Miss Colinette Hazel +44 (0)20 7594 2725

 
//

Location

 

203Sir Michael Uren HubWhite City Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Burn:2018:10.1136/bmjopen-2017-020977,
author = {Burn, E and Liddle, AD and Hamilton, TW and Judge, A and Pandit, HG and Murray, DW and Pinedo-Villanueva, R},
doi = {10.1136/bmjopen-2017-020977},
journal = {BMJ Open},
title = {Cost-effectiveness of unicompartmental compared with total knee replacement: A population-based study using data from the National Joint Registry for England and Wales},
url = {http://dx.doi.org/10.1136/bmjopen-2017-020977},
volume = {8},
year = {2018}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objectives To assess the value for money of unicompartmental knee replacement (UKR) compared with total knee replacement (TKR).Design A lifetime Markov model provided the framework for the analysis.Setting Data from the National Joint Registry (NJR) for England and Wales primarily informed the analysis.Participants Propensity score matched patients in the NJR who received either a UKR or TKR.Interventions UKR is a less invasive alternative to TKR, where only the compartment affected by osteoarthritis is replaced.Primary outcome measures Incremental quality-adjusted life years (QALYs) and healthcare system costs.Results The provision of UKR is expected to lead to a gain in QALYs compared with TKR for all age and gender subgroups (male: <60 years: 0.12, 60–75 years: 0.20, 75+ years: 0.19; female: <60 years: 0.10, 60–75 years: 0.28, 75+ years: 0.44) and a reduction in costs (male: <60: £−1223, 60–75 years: £−1355, 75+ years: £−2005; female: <60 years: £−601, 60–75 years: £−935, 75+ years: £−1102 per patient over the lifetime). UKR is expected to lead to a reduction in QALYs compared with TKR when performed by surgeons with low UKR utilisation but an increase among those with high utilisation (<10%, median 6%: −0.04, ≥10%, median 27%: 0.26). Regardless of surgeon usage, costs associated with UKR are expected to be lower than those of TKR (<10%: £−127, ≥10%: £−758).Conclusions UKR can be expected to generate better health outcomes and lower lifetime costs than TKR. Surgeon usage of UKR does, however, have a significant impact on the cost-effectiveness of the procedure. To achieve the best results, surgeons need to perform a sufficient proportion of knee replacements as UKR. Low usage surgeons may therefore need to broaden their indications for UKR.
AU  - Burn,E
AU  - Liddle,AD
AU  - Hamilton,TW
AU  - Judge,A
AU  - Pandit,HG
AU  - Murray,DW
AU  - Pinedo-Villanueva,R
DO  - 10.1136/bmjopen-2017-020977
PY  - 2018///
SN  - 2044-6055
TI  - Cost-effectiveness of unicompartmental compared with total knee replacement: A population-based study using data from the National Joint Registry for England and Wales
T2  - BMJ Open
UR  - http://dx.doi.org/10.1136/bmjopen-2017-020977
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000435176700217&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/69898
VL  - 8
ER  -
Download