The Cost-Effectiveness of a Midvastus Versus Standard Medial Parapatellar Surgical Approach for Total Knee Arthroplasty
Abstract
The minimally invasive midvastus (MMV) surgical approach for total knee arthroplasty (TKA) is a less invasive technique that has been proposed to accelerate recovery over standard TKA, however, advantages are not yet definitively established. We investigated the cost-effectiveness of MMV TKA versus the standard medial parapatellar (MPP) approach for TKA alongside a randomized controlled trial in patients with knee osteoarthritis. Patients reported resource use as well as indirect costs, and health outcomes were measured using the EQ-5D-5L and the Western Ontario and McMaster Universities Osteoarthritis Index over the 12-month study period. The results of our net benefit regression analysis suggest MMV TKA may be cost-effective compared to MPP TKA from the payer perspective at willingness-to-pay (WTP) values between $1000 and $2000, and WTP values between $2000 and $20,000 from the societal perspective.