Wednesday, September 8, 2021


Silver-coated megaprostheses could also be a cheap choice for limb salvage surgical procedure

September 07, 2021 2 min learn Supply/Disclosures Revealed by: Supply: Ramkumar DB, et al. Paper 161. Introduced at: American…

By Staff , in Silver , at September 7, 2021


September 07, 2021

2 min learn


Supply/Disclosures

Supply:

Ramkumar DB, et al. Paper 161. Introduced at: American Academy of Orthopaedic Surgeons Annual Assembly. Aug. 31-Sept. 3, 2021; San Diego.


Disclosures:
Ramkumar experiences no related monetary disclosures.


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SAN DIEGO — After broad resection of decrease extremity osteosarcoma, use of a silver-coated megaprostheses for reconstruction could also be cost-effective at mitigating prosthetic joint infections vs. use of ordinary implants, in line with outcomes.

Dipak B. Ramkumar, MD, and colleagues created a computational cost-effectiveness mannequin by assembling a wholesome cohort of sufferers with localized osteosarcoma that had been amenable to limb salvage with endoprosthetic reconstruction.

“We then created an anticipated worth cost-effectiveness mannequin utilizing the payoff price in inflation adjusted 2020 U.S. {dollars}, representing the direct medical prices alone and effectiveness in quality-adjusted life expectancy in days,” Ramkumar stated in his presentation on the American Academy of Orthopaedic Surgeons Annual Assembly.

Dipak B. Ramkumar

Dipak B. Ramkumar

Researchers additionally ascertained numerous issues, possibilities, utility values and direct medical prices related to numerous well being states by means of a assessment of the medical literature and used a willingness-to-pay threshold of $100,000.

Ramkumar famous they recognized an total common technique price of roughly $45,446, with an related effectiveness of about 11,824 quality-adjusted life-days after accounting for the potential transition states and outcomes that may occur after present process a typical implant replantation for reconstruction.

“The silver-coated implant had a technique price of roughly $64,254, with an related effectiveness of 11,989 quality-adjusted life-days,” Ramkumar stated. “So, this then confers an incremental cost-effectiveness ratio of roughly $114.12 per quality-adjusted life-days translated right into a yr of about roughly $42,000 per quality-adjusted life- yr.”

One-way sensitivity analyses wanting on the chance of prosthetic joint an infection with a typical implant and with a silver-coated implant confirmed that the usual implant is most well-liked when the chance of a prosthetic joint an infection in a typical implant is lower than 8%, in line with Ramkumar.

“The second that an infection fee will increase past 8%, the silver implant is much extra price -effective on the longer scale,” Ramkumar stated.

Equally, he added the silver-coated implant was cheaper when the chance of an an infection with a silver-coated implant was lower than 13%.

“We then simulated a Monte Carlo evaluation the place we … repeated the cycle of going by means of the varied phases and transition state of our mannequin for this assembled cohort and we discovered that with 73.5% confidence, we may successfully say that the silver-coated implants are most well-liked once we use a willingness-to-pay threshold of $100,000,” Ramkumar stated. “That quantity will increase while you decrease the willingness-to-pay threshold to $50,000 and even $30,000.”



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