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Unloading knee brace is a cost-effective method to bridge and delay surgery in unicompartmental knee arthritis

Paul YF Lee, Thomas Winfield Orcid Logo, Shaun Harris Orcid Logo, Emerald Storey, Amit Chandratreya

BMJ Open Sport & Exercise Medicine, Volume: 2, Issue: 1, Start page: e000195

Swansea University Authors: Thomas Winfield Orcid Logo, Shaun Harris Orcid Logo

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DOI (Published version): 10.1136/bmjsem-2016-000195

Abstract

AbstractBackground Unloading knee braces can provide good short-term pain relief for some patients with unicompartmental osteoarthritis (UOA). Their cost is relatively small compared with surgical interventions. However, no previous studies have reported their use over a duration of 5 years or more....

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Published in: BMJ Open Sport & Exercise Medicine
ISSN: 2055-7647
Published: 2017
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URI: https://cronfa.swan.ac.uk/Record/cronfa32866
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2017-10-31T10:44:56.7356290</datestamp><bib-version>v2</bib-version><id>32866</id><entry>2017-03-30</entry><title>Unloading knee brace is a cost-effective method to bridge and delay surgery in unicompartmental knee arthritis</title><swanseaauthors><author><sid>24607f91596836a24f43c2280ffda02a</sid><ORCID>0000-0002-5306-3027</ORCID><firstname>Thomas</firstname><surname>Winfield</surname><name>Thomas Winfield</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>10b1bd08dbad1f2681ff1e527af9f9a3</sid><ORCID>0000-0001-7724-6621</ORCID><firstname>Shaun</firstname><surname>Harris</surname><name>Shaun Harris</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2017-03-30</date><deptcode>HHE</deptcode><abstract>AbstractBackground Unloading knee braces can provide good short-term pain relief for some patients with unicompartmental osteoarthritis (UOA). Their cost is relatively small compared with surgical interventions. However, no previous studies have reported their use over a duration of 5 years or more.Methods Up to 8 years of prospective data were collected from 63 patients who presented with UOA. After conservative management with analgesia and physiotherapy, patients were offered an unloading brace. EQ-5D (EuroQol five dimensions) questionnaires were collected at baseline and after wearing the brace. Cost and quality-adjusted life years (QALYs) were compared with a total knee replacement (TKR) with an 8-month waiting duration and 8 years of results.Results Patients experienced a mean increase in EQ-5D of 0.42 with an average duration of wear of 26.1 months resulting in an increase of 0.44 in QALYs with a mean cost of &#xA3;625. The adoption of an unloader knee brace was found to be a short-term cost-effective treatment option with an 8-month incremental cost effectiveness ratio of &#xA3;9599. Compared with no treatment, the unloader knee brace can be considered cost effective at 4 months or more. At 8 years follow-up, the unloader knee brace demonstrated QALYs gain of 0.43 and with an incremental cost-effectiveness ratio of -&#xA3;6467 compared with TKR.Conclusion Unloading knee braces are cost effective for the management of UOA. These findings strongly support the undertaking of further research into the long-term impact of unloading knee brace. The unloader knee brace has benefits to the National Health Service for capacity, budget, waiting list duration, frequency of surgery and reducing the required severity of surgical intervention.</abstract><type>Journal Article</type><journal>BMJ Open Sport &amp; Exercise Medicine</journal><volume>2</volume><journalNumber>1</journalNumber><paginationStart>e000195</paginationStart><publisher/><issnElectronic>2055-7647</issnElectronic><keywords/><publishedDay>24</publishedDay><publishedMonth>1</publishedMonth><publishedYear>2017</publishedYear><publishedDate>2017-01-24</publishedDate><doi>10.1136/bmjsem-2016-000195</doi><url/><notes/><college>COLLEGE NANME</college><department>Swansea Centre for Health Economics</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HHE</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2017-10-31T10:44:56.7356290</lastEdited><Created>2017-03-30T17:10:13.8455069</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">School of Health and Social Care</level></path><authors><author><firstname>Paul YF</firstname><surname>Lee</surname><order>1</order></author><author><firstname>Thomas</firstname><surname>Winfield</surname><orcid>0000-0002-5306-3027</orcid><order>2</order></author><author><firstname>Shaun</firstname><surname>Harris</surname><orcid>0000-0001-7724-6621</orcid><order>3</order></author><author><firstname>Emerald</firstname><surname>Storey</surname><order>4</order></author><author><firstname>Amit</firstname><surname>Chandratreya</surname><order>5</order></author></authors><documents><document><filename>0032866-11042017085819.pdf</filename><originalFilename>e000195.full.pdf</originalFilename><uploaded>2017-04-11T08:58:19.8900000</uploaded><type>Output</type><contentLength>843741</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><embargoDate>2017-01-24T00:00:00.0000000</embargoDate><documentNotes>This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license.</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language></document></documents><OutputDurs/></rfc1807>
spelling 2017-10-31T10:44:56.7356290 v2 32866 2017-03-30 Unloading knee brace is a cost-effective method to bridge and delay surgery in unicompartmental knee arthritis 24607f91596836a24f43c2280ffda02a 0000-0002-5306-3027 Thomas Winfield Thomas Winfield true false 10b1bd08dbad1f2681ff1e527af9f9a3 0000-0001-7724-6621 Shaun Harris Shaun Harris true false 2017-03-30 HHE AbstractBackground Unloading knee braces can provide good short-term pain relief for some patients with unicompartmental osteoarthritis (UOA). Their cost is relatively small compared with surgical interventions. However, no previous studies have reported their use over a duration of 5 years or more.Methods Up to 8 years of prospective data were collected from 63 patients who presented with UOA. After conservative management with analgesia and physiotherapy, patients were offered an unloading brace. EQ-5D (EuroQol five dimensions) questionnaires were collected at baseline and after wearing the brace. Cost and quality-adjusted life years (QALYs) were compared with a total knee replacement (TKR) with an 8-month waiting duration and 8 years of results.Results Patients experienced a mean increase in EQ-5D of 0.42 with an average duration of wear of 26.1 months resulting in an increase of 0.44 in QALYs with a mean cost of £625. The adoption of an unloader knee brace was found to be a short-term cost-effective treatment option with an 8-month incremental cost effectiveness ratio of £9599. Compared with no treatment, the unloader knee brace can be considered cost effective at 4 months or more. At 8 years follow-up, the unloader knee brace demonstrated QALYs gain of 0.43 and with an incremental cost-effectiveness ratio of -£6467 compared with TKR.Conclusion Unloading knee braces are cost effective for the management of UOA. These findings strongly support the undertaking of further research into the long-term impact of unloading knee brace. The unloader knee brace has benefits to the National Health Service for capacity, budget, waiting list duration, frequency of surgery and reducing the required severity of surgical intervention. Journal Article BMJ Open Sport & Exercise Medicine 2 1 e000195 2055-7647 24 1 2017 2017-01-24 10.1136/bmjsem-2016-000195 COLLEGE NANME Swansea Centre for Health Economics COLLEGE CODE HHE Swansea University 2017-10-31T10:44:56.7356290 2017-03-30T17:10:13.8455069 Faculty of Medicine, Health and Life Sciences School of Health and Social Care Paul YF Lee 1 Thomas Winfield 0000-0002-5306-3027 2 Shaun Harris 0000-0001-7724-6621 3 Emerald Storey 4 Amit Chandratreya 5 0032866-11042017085819.pdf e000195.full.pdf 2017-04-11T08:58:19.8900000 Output 843741 application/pdf Version of Record true 2017-01-24T00:00:00.0000000 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license. true eng
title Unloading knee brace is a cost-effective method to bridge and delay surgery in unicompartmental knee arthritis
spellingShingle Unloading knee brace is a cost-effective method to bridge and delay surgery in unicompartmental knee arthritis
Thomas Winfield
Shaun Harris
title_short Unloading knee brace is a cost-effective method to bridge and delay surgery in unicompartmental knee arthritis
title_full Unloading knee brace is a cost-effective method to bridge and delay surgery in unicompartmental knee arthritis
title_fullStr Unloading knee brace is a cost-effective method to bridge and delay surgery in unicompartmental knee arthritis
title_full_unstemmed Unloading knee brace is a cost-effective method to bridge and delay surgery in unicompartmental knee arthritis
title_sort Unloading knee brace is a cost-effective method to bridge and delay surgery in unicompartmental knee arthritis
author_id_str_mv 24607f91596836a24f43c2280ffda02a
10b1bd08dbad1f2681ff1e527af9f9a3
author_id_fullname_str_mv 24607f91596836a24f43c2280ffda02a_***_Thomas Winfield
10b1bd08dbad1f2681ff1e527af9f9a3_***_Shaun Harris
author Thomas Winfield
Shaun Harris
author2 Paul YF Lee
Thomas Winfield
Shaun Harris
Emerald Storey
Amit Chandratreya
format Journal article
container_title BMJ Open Sport & Exercise Medicine
container_volume 2
container_issue 1
container_start_page e000195
publishDate 2017
institution Swansea University
issn 2055-7647
doi_str_mv 10.1136/bmjsem-2016-000195
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care
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description AbstractBackground Unloading knee braces can provide good short-term pain relief for some patients with unicompartmental osteoarthritis (UOA). Their cost is relatively small compared with surgical interventions. However, no previous studies have reported their use over a duration of 5 years or more.Methods Up to 8 years of prospective data were collected from 63 patients who presented with UOA. After conservative management with analgesia and physiotherapy, patients were offered an unloading brace. EQ-5D (EuroQol five dimensions) questionnaires were collected at baseline and after wearing the brace. Cost and quality-adjusted life years (QALYs) were compared with a total knee replacement (TKR) with an 8-month waiting duration and 8 years of results.Results Patients experienced a mean increase in EQ-5D of 0.42 with an average duration of wear of 26.1 months resulting in an increase of 0.44 in QALYs with a mean cost of £625. The adoption of an unloader knee brace was found to be a short-term cost-effective treatment option with an 8-month incremental cost effectiveness ratio of £9599. Compared with no treatment, the unloader knee brace can be considered cost effective at 4 months or more. At 8 years follow-up, the unloader knee brace demonstrated QALYs gain of 0.43 and with an incremental cost-effectiveness ratio of -£6467 compared with TKR.Conclusion Unloading knee braces are cost effective for the management of UOA. These findings strongly support the undertaking of further research into the long-term impact of unloading knee brace. The unloader knee brace has benefits to the National Health Service for capacity, budget, waiting list duration, frequency of surgery and reducing the required severity of surgical intervention.
published_date 2017-01-24T03:40:26Z
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