One limitation of the analysis is that data came from multiple sources, with the potential for selection bias on clinical outcomes and wide variation in methods for assessing effectiveness, the study team notes.
“The authors of this study did review the evidence on the benefits of total knee replacement and how failure rates vary with BMI, so assumptions were based on prior studies,” says David Howard, PhD, a professor and health economist at Emory University, Atlanta, who wasn’t involved in the study.
Because most insurance plans already cover this procedure, it’s also not likely that the study results would have an impact on which patients might be eligible for surgery, Dr. Howard says by email.
“Clinicians generally don’t consider cost when deciding which treatment to recommend,” Dr. Howard says. “However, the results of this study could make them feel more comfortable recommending total knee replacement to obese patients.”
Reference
- Chen AT, Bronsther CI, Stanley EE, et al. The value of total knee replacement in patients with knee osteoarthritis and a body mass index of 40 kg/m2 or greater: A cost-effectiveness analysis. Ann Intern Med. 2021 Mar 23.
