OBJECTIVES : Improved assessment of knee function would support the conservative management of knee osteoarthritis (OA). Knee kinesiography (KneeKG) is a new dynamic exam assessing biomechanical risk factors for OA progression. In a multi-arm cluster randomized clinical trial, significant improvements on clinical symptoms, pain, and daily activities in the Knee Injury and Osteoarthritis Outcome Score (KOOS) were reported in both KneeKG groups (all p<0.05) (Cagnin A. et al. 2019). The present study aimed to introduce a conceptual framework for assessing the economic value of the KneeKG in the management of knee OA in a primary care setting.

METHODS : Findings from the clinical trial and a targeted literature review were used to inform the KneeKG model framework conceptualisation. We compared three global care strategies (current medical management [CMM], CMM+KneeKG, and CMM+KneeKG+Education), as was done in the clinical trial. The expert panel consisted of Health Technology Assessment specialists and clinicians to guide key decisions in model design. The clinical and safety outcomes, health states, technical assumptions, economic endpoints, and costs were evaluated to identify the key value drivers to optimize the development of the proposed models.

RESULTS : OA severity index was used to define the health states based on the clinical validation. The severity of knee OA was defined by the Kellgren and Lawrence grading system where grades 2, 3, and 4 are mild, moderate, and severe. The outcome was defined as global care strategies adherence, and the related costs. Costs were estimated for diagnostic tests, drugs, routine care, complications, adverse events, productivity costs, and mortality.

CONCLUSIONS : The clinical effectiveness of the KneeKG exam in the conservative management of knee OA was previously reported. Based on clinical trial and targeted literature review, a health economic model was designed to evaluate the KneeKG.