Authors (including presenting author) :
So, Karen HT (1); Chan, TK (1); Yang, Adam ZW (1); Chan, Angus CK (1); Man, SW (1); Wong, John KF (1); Li, KK (1); & Li, Wilson (1)
Affiliation :
(1) Department of Orthopaedics and Traumatology, Queen Elizabeth Hospital
Introduction :
In an aging population, degenerative diseases especially musculoskeletal (MSK) disorders become a huge burden on our healthcare system. With limited resources, the allocation of funds and supplies must be carefully distributed towards diseases and management with the biggest impact and is the most cost-efficient.
In Hong Kong, the three degenerative MSK diseases that burden our healthcare system include osteoarthritis of the knee, hallux valgus (HV) and focal lumbar spinal stenosis (FLSS). Their associated treatment includes; total knee replacement (TKR) for osteoarthritis of the knee, corrective osteotomy for hallux valgus and decompressive surgery with or without fusion for FLSS. Studies have shown that primary TKR has proved to be the most cost-effective surgical intervention in terms of improvement of quality of life and durable treatment.
Objectives :
This study aims to use clinical and cost-utility data to compare the relative improvement in QoL after surgical intervention for HV and FLSS in comparison to OAK and whether improvement in health-related QoL (HRQoL) after surgical intervention is sustainable over time.
Methodology :
This is a retrospective, single-center cohort study. Using clinical and cost-utility data from the center’s previous presented OAK, FLSS and HV cohorts, we will compare the relative improvement in quality of life after surgical intervention for the three conditions.
Result & Outcome :
There was significant improvement in both function scores and quality of life after surgery compared with conservative treatment for all 3 diseases. All three surgeries were shown to be cost-saving treatment strategies with minimal clinically important differences and significant QALY gained. In addition, there was significant improvement in HRQoL after surgical treatment that was sustained for a minimum of 3-years for all three diseases.
