Preoperative Interventions and Charges Before Total Knee Arthroplasty

Area of Science:

• Orthopedic surgery
• Health economics
• Medical billing and costs

Background:

• Total knee arthroplasty (TKA) cost-effectiveness is established.
• Limited data exist on preoperative interventions and their associated costs before TKA.

Purpose of the Study:

• To examine preoperative interventions and their charges within two years preceding TKA.

Main Methods:

• Retrospective cohort analysis of TKA patients (2007-2011).
• Utilized the PearlDiver Patient Record Database.
• Tracked inpatient and outpatient billing records for two years prior to TKA.

Main Results:

• Average preoperative charges: $3545.82 (Medicare) and $3281.57 (United Healthcare).
• 21.4-23.3% of patients had MRI; 31.9-45.6% within 3 months of TKA.
• 49.4-63.2% had intra-articular injections; 29.4-44.8% within 3 months of TKA.

Conclusions:

• Preoperative interventions and costs concentrate within six months, often within three months, before TKA.
• These interventions may lack clinical or cost-effectiveness for patients with moderate-to-severe osteoarthritis.
• Earlier TKA and foregoing unnecessary preoperative interventions could reduce costs and procedures.