Cost-effectiveness of patient specific vs conventional instrumentation for total knee arthroplasty:A systematic review and meta-analysis  

作　　者：Isobel M Dorling Lars Geenen Marion J L F Heymans Jasper Most Bert Boonen Martijn G M Schotanus 

机构地区：[1]Department of Orthopaedic Surgery and Traumatology,Zuyderland Medical Center,Sittard-Geleen 6162 BG,Limburg,Netherlands [2]Zuyderland Academy,Zuyderland Medical Center,Sittard-Geleen 6155 NH,Limburg,Netherlands [3]School of Care and Public Health Research Institute(CAPHRI),Faculty of Health,Medicine and Life Sciences,Maastricht 6229 ER,Limburg,Netherlands [4]Department of Orthopaedic Surgery and Traumatology,Maastricht University Medical Center,Maastricht 6229 HX,Limburg,Netherlands

出　　处：《World Journal of Orthopedics》2023年第6期458-470,共13页世界骨科杂志（英文版）

摘　　要：BACKGROUND Over the past years,patient specific instrumentation(PSI)for total knee arthroplasty(TKA)has been implemented and routinely used.No clear answer has been given on its associated cost and cost-effectiveness when compared to conventional instrumentation(CI)for TKA.AIM To compare the cost and cost-effectiveness of PSI TKA compared to CI TKA.METHODS A literature search was performed in healthcare,economical healthcare,and medical databases(MEDLINE,EMBASE,CINAHL,Web of Science,Cochrane Library,EconLit).It was conducted in April 2021 and again in January 2022.Relevant literature included randomised controlled trials,retrospective studies,prospective studies,observational studies,and case control studies.All studies were assessed on methodological quality.Relevant outcomes included incremental cost-effectiveness ratio,quality-adjusted life years,total costs,imaging costs,production costs,sterilization associated costs,surgery duration costs and readmission rate costs.All eligible studies were assessed for risk of bias.Meta-analysis was performed for outcomes with sufficient data.RESULTS Thirty-two studies were included into the systematic review.Two were included in the metaanalysis.3994 PSI TKAs and 13267 CI TKAs were included in the sample size.The methodological quality of the included studies,based on Consensus on Health Economic Criteria-scores and risk of bias,ranged from average to good.PSI TKA costs less than CI TKA when considering mean operating room time and its associated costs and tray sterilization per patient case.PSI TKA costs more compared to CI TKA when considering imaging and production costs.Considering total costs per patient case,PSI TKA is more expensive in comparison to CI TKA.Meta-analysis comparing total costs for PSI TKA,and CI TKA showed a significant higher cost for PSI TKA.CONCLUSION Cost for PSI and CI TKA can differ when considering distinct aspects of their implementation.Total costs per patient case are increased for PSI TKA when compared to CI TKA.

关 键 词：Total knee arthroplasty Patient specific instrumentation Instrumentation for total knee arthroplasty COST-EFFECTIVENESS Systematic review 

分 类 号：R687.4[医药卫生—骨科学]