Cost-effectiveness of bariatric surgery before TKR

Editor's Note

Bariatric surgery before total knee replacement (TKR) is cost-effective in improving outcomes in obese patients, this study finds.

Researchers used a computer software program to compare the cost utility of two treatment protocols for patients who were morbidly obese and had advanced knee osteoarthritis.

The model predicted that patients who had bariatric surgery 2 years before TKR were more likely to have an improved quality of life, measured in quality–adjusted life years (QALY), compared to patients without surgery.

The cost necessary for this level of improvement was $13,910 per QALY, which is well below the amount insurance companies and Medicare are typically willing to pay, the authors say.

Background: Obesity is associated with adverse outcomes and increased costs after total knee arthroplasty. Bariatric surgery is an effective treatment for morbid obesity, but its cost-effectiveness for weight loss prior to total knee arthroplasty is unknown.