Quality-Adjusted Life Year Gains After Total Hip and Knee Arthroplasty: A Review of Cost-Effectiveness Evidence and Policy Implications.

The use of health-related quality of life (HRQoL) instruments and quality-adjusted life years (QALYs) has led to a better understanding of cost-effectiveness and quality-of-life improvements after total joint arthroplasty (TJA). The purpose of this review was to characterize the effect that primary TJA has on QALYs. Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are both highly cost-effective interventions that provide patients with reliable improvements in quality of life and overall satisfaction. A THA is more cost-effective than a TKA; however, both procedures drastically improve patient QALY. As reimbursement for primary TKA and THA continues to decline and administrative and regulatory burdens increase, there is growing concern regarding patient access to these procedures. Reimbursement policy must take into account the unique value of TKA and THA to ensure that patients have timely access to these interventions that reliably restore independence and reduce long-term healthcare utilization.