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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 G Winfield; Shaun RS Harris; Emerald Storey; Amit Chandratreya

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

Swansea University Author: Harris, Shaun

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Abstract

Background 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...

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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/cronfa32868
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2017-04-11T14:40:31Z</datestamp><bib-version>v2</bib-version><id>32868</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><alternativeTitle></alternativeTitle><author>Shaun Harris</author><firstname>Shaun</firstname><surname>Harris</surname><active>true</active><ORCID>0000-0001-7724-6621</ORCID><ethesisStudent>false</ethesisStudent><sid>10b1bd08dbad1f2681ff1e527af9f9a3</sid><email>d771121cd894dbb900e1e629a60ace65</email><emailaddr>ODz8c1LaEIlqrOvHRlXlFX2HZhUyFASdV1DFdgIIhKs=</emailaddr><date>2017-03-30</date><deptcode>HHE</deptcode><abstract>Background 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><paginationEnd/><publisher></publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>2055-7647</issnElectronic><keywords></keywords><publishedDay>21</publishedDay><publishedMonth>2</publishedMonth><publishedYear>2017</publishedYear><publishedDate>2017-02-21</publishedDate><doi>10.1136/bmjsem-2016-000195</doi><url></url><notes></notes><college>College of Human and Health Sciences</college><department>Swansea Centre for Health Economics</department><CollegeCode>CHHS</CollegeCode><DepartmentCode>HHE</DepartmentCode><institution/><researchGroup>Health Technology Assessment/Health Economics</researchGroup><supervisor/><sponsorsfunders/><grantnumber/><degreelevel/><degreename>None</degreename><lastEdited>2017-04-11T14:40:31Z</lastEdited><Created>2017-03-30T17:14:43Z</Created><path><level id="1">College of Human and Health Sciences</level><level id="2">Swansea Centre for Health Economics</level></path><authors><author><firstname>Paul YF</firstname><surname>Lee</surname><orcid/><order>1</order></author><author><firstname>Thomas G</firstname><surname>Winfield</surname><orcid/><order>2</order></author><author><firstname>Shaun RS</firstname><surname>Harris</surname><orcid/><order>3</order></author><author><firstname>Emerald</firstname><surname>Storey</surname><orcid/><order>4</order></author><author><firstname>Amit</firstname><surname>Chandratreya</surname><orcid/><order>5</order></author></authors><documents><document><filename>0032868-11042017143832.pdf</filename><originalFilename>e000195v2.pdf</originalFilename><uploaded>2017-04-11T14:38:32Z</uploaded><type>Output</type><contentLength>843741</contentLength><contentType>application/pdf</contentType><version>VoR</version><cronfaStatus>true</cronfaStatus><action>Updated Copyright</action><actionDate>11/04/2017</actionDate><embargoDate>2017-02-21T00:00:00</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></rfc1807>
spelling 2017-04-11T14:40:31Z v2 32868 2017-03-30 Unloading knee brace is a cost-effective method to bridge and delay surgery in unicompartmental knee arthritis Shaun Harris Shaun Harris true 0000-0001-7724-6621 false 10b1bd08dbad1f2681ff1e527af9f9a3 d771121cd894dbb900e1e629a60ace65 ODz8c1LaEIlqrOvHRlXlFX2HZhUyFASdV1DFdgIIhKs= 2017-03-30 HHE Background 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 21 2 2017 2017-02-21 10.1136/bmjsem-2016-000195 College of Human and Health Sciences Swansea Centre for Health Economics CHHS HHE Health Technology Assessment/Health Economics None 2017-04-11T14:40:31Z 2017-03-30T17:14:43Z College of Human and Health Sciences Swansea Centre for Health Economics Paul YF Lee 1 Thomas G Winfield 2 Shaun RS Harris 3 Emerald Storey 4 Amit Chandratreya 5 0032868-11042017143832.pdf e000195v2.pdf 2017-04-11T14:38:32Z Output 843741 application/pdf VoR true Updated Copyright 11/04/2017 2017-02-21T00:00:00 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
Harris, Shaun
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 10b1bd08dbad1f2681ff1e527af9f9a3
author_id_fullname_str_mv 10b1bd08dbad1f2681ff1e527af9f9a3_***_Harris, Shaun
author Harris, Shaun
author2 Paul YF Lee
Thomas G Winfield
Shaun RS 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 College of Human and Health Sciences
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hierarchy_top_title College of Human and Health Sciences
hierarchy_parent_id collegeofhumanandhealthsciences
hierarchy_parent_title College of Human and Health Sciences
department_str Swansea Centre for Health Economics{{{_:::_}}}College of Human and Health Sciences{{{_:::_}}}Swansea Centre for Health Economics
document_store_str 1
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researchgroup_str Health Technology Assessment/Health Economics
description Background 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 2017-02-21T04:49:55Z
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