OBJECTIVES: Surgical procedures for knee osteoarthritis mainly include high tibial osteotomy (HTO), unicompartmental knee arthroplasty (UKA), and total knee arthroplasty (TKA). There is no recent data available on the volume and cost associated with HTO and UKA which are the common treatments among younger patients with unicompartmental knee OA. This study estimated the number of patients receiving HTO, UKA or TKA and its costs for years 2012 through 2016 in the United states (US).

METHODS: This retrospective study included Truven Health MarketScan Commercial Claims and Encounters database from 2012 to 2016. Patients with age less than 65 years receiving HTO, UKA or primary TKA were identified. Projected volume of patients receiving these treatments were reported over years. Average payment for each treatment was categorized by facility and professional payments. All payments were adjusted for inflation to 2016 US dollars.

RESULTS: The number of patients identified ranged from 23,504-24,907 for HTO; 21,981-32,484 for UKA and 274,832-302,181 for TKA from 2012-2016. The average (SD) age for patients was 41.69 (16.07) years with 54.5% females for HTO, 55.37 (6.27) years with 49.63% females for UKA and 56.80 (5.47) years with 57.59% females for TKA in 2016. The average facility payments ranged from $21,306-$30,421 for HTO; $24,332-$28,058 for UKA and $28,756-$31,670 for TKA while the average professional payments ranged from $4,496-$5,150 for HTO; $4,041-$4,326 for UKA and $4,613-$5,208 for TKA over years.

CONCLUSIONS: Given the high volume of surgical knee procedures in recent years with aging population, surgical failure requiring revision surgery will be a major risk for patients receiving HTO, UKA or TKA. Procedures that improve longevity of the surgery and improve physical activity may be warranted. Future research could evaluate the risk for revision surgery and the associated economic burden after HTO, UKA or TKA.