[Valgus tibial head reconstruction, monocondylar sled prosthesis or bicondylar gliding surface replacement in therapy of medial gonarthrosis--a cost analysis].
OBJECTIVE
Three to a certain extent competing methods for the treatment of unicompartmental osteoarthritis of the knee are compared regarding the costs they cause. These methods comprise the high tibial valgus osteotomy (HTO), the unicompartmental knee arthroplasty (UKA), and the total knee arthroplasty (TKA).


METHODS
We compared the in-patient costs and out-patient costs of 20 patients (drawn by lot) in each group who received one of the above-named operative methods at our hospital between 1988 and 1993. The results were extrapolated according to the expected survival rate of the applied method.


RESULTS
The average total costs of patients who received a HTO were 9.487,-; for the unicompartmental arthroplasty the average cost were 11.687,-; the implantation of a TKA resulted in average costs of 16.940,-. All operative procedures exceeded a particular global amount, the socalled "Fallpauschale".


CONCLUSIONS
Regarding the total costs that arise for the operative treatment of the degenerative arthritis of the knee, the HTO (with or without hardware removal) proves to be the cheapest of the applied methods. Projecting the results on the survival rate of each treatment method, no statistically significant differences could be recognized between the three operative procedures.
Rudert
M
M
Orthopädische Klinik der Medizinischen Hochschule Hannover im Annastift. rudert@annastift.de
Galla
M
M
Ackermann
B
B
Stukenborg-Colsman
C
C
Wirth
C J
CJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000191:economics; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D005260:Female; D005858:Germany; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D007720:Knee Prosthesis / Q000191:economics*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000191:economics* / Q000601:surgery; D010027:Osteotomy / Q000191:economics*; D011474:Prosthesis Design / Q000191:economics; D011859:Radiography
Valgisierende Tibiakopfumstellung, monokondyläre Schlittenprothese oder bikondylärer Gleitflächenersatz zur Therapie der medialen Gonarthrose--eine Kostenstrukturanalyse.