OBJECTIVE: To determine the cost-effectiveness of arthroscopic surgery in addition to non-operative treatments compared with non-operative treatments alone in @entity1 with @entity626 ( @entity571 ). DESIGN, SETTING AND @entity1 : We conducted an economic evaluation alongside a single-centre, randomised trial among @entity1 with symptomatic, radiographic knee @entity571 (KL grade >=  2). INTERVENTIONS: @entity1 received arthroscopic debridement and partial resection of degenerative knee tissues in addition to optimised non-operative therapy, or optimised non-operative therapy only. MAIN OUTCOME MEASURES: Direct and indirect costs were collected prospectively over the 2-year study period. The effectiveness outcomes were the Western Ontario @entity571 Index (WOMAC) and quality-adjusted life years (QALYs). Cost-effectiveness was estimated using the net benefit regression framework considering a range of willingness-to-pay values from the Canadian public payer and societal perspectives. We calculated @entity24882 and conducted sensitivity analyses using the extremes of the 95% CIs surrounding mean differences in effect between groups. RESULTS: 168 @entity1 were included. @entity1 allocated to arthroscopy received partial resection and debridement of @entity179 (81%) and/or articular cartilage (97%). There were no significant differences between groups in use of non-operative treatments. The incremental net benefit was negative for all willingness-to-pay values. Uncertainty estimates suggest that even if willing to pay  400,000 to achieve a clinically important improvement in WOMAC score, or >=  50,000 for an additional QALY, there is <20% probability that the addition of arthroscopy is cost-effective compared with non-operative therapies only. Our sensitivity analysis suggests that even when assuming the largest treatment effect, the addition of arthroscopic surgery is not economically attractive compared with non-operative treatments only. CONCLUSIONS: Arthroscopic debridement of @entity179 and resection of @entity179 in addition to non-operative treatments for knee @entity571 is not an economically attractive treatment option compared with non-operative treatment only, regardless of willingness-to-pay value. TRIAL REGISTRATION NUMBER: NCT00158431.

Cost-effectiveness analysis of arthroscopic surgery compared with non-operative management for XXXX of the knee.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'PARTICIPANTS'] @entity626 :: ('MESH:D020370', 'Disease') :: ['knee osteoarthritis'] @entity24882 :: ('MESH:D065606', 'Disease') :: ['incremental cost-effectiveness ratios'] @entity571 :: ('MESH:D010003', 'Disease') :: ['OA', 'McMaster Osteoarthritis'] @entity179 :: ('MESH:D019636', 'Disease') :: ['degenerative articular cartilage', 'degenerative meniscal tears']
@entity571 :: (MESH:D010003,Disease) :: ['osteoarthritis']
