Cost-Benefit Analysis of Synovectomy of the Knee

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Abstract
The subject of this study was the cost-benefit ratio of synovectomy of the knee. Synovectomy of the knee is the most common operation at the Rheumatism Foundation Hospital, Heinola. In 1973 it accounted for 8.8% of all orthopedic operations performed. The survey material comprises 225 synovectomies of the knee performed on 208 patients. The age and sex distribution of the patients has been obtained from the material for 1973. The second series consists of 181 patients who underwent synovectomy of the knee during the period 1960-65 and who were re-examined in 1970-75. From the said material, data have been obtained on the postoperative professional working activity of patients and on the number of other hospital treatments given to these patients. These coefficients have been transferred to relate to the year 1973. Of those patients who underwent an operation in 1973, 70.9% were women and 29.1% were men. Their average age at the time of operation was 41 years. Their working age was 24 years on average. The operation and related total patient treatment inclusive of other orthopedic operations constitute a vital measure of the preservation of the patient's working ability. Cost-benefit analysis was the research method employed. The year 1973 was chosen as the period for investigation. Costs due to synovectomy of the knee amounted in 1973 to about 1.6 million marks. Total costs averaged 7 000 marks per operation. The greatest potential benefits accruing from synovectomies of the knee prove to be multiple as compared with costs. Reckoned according to different rates of interest (6% and 9%) maximum benefits are about 8.2-9.8 million marks. As compared with costs, benefits are approx. 5.2-6.2 times as great. Maximum net benefits per one operation are about 43 770 marks. Operations can be regarded as economically justifiable even in those cases where it is possible to preserve working ability for a period of 10 years for 10% of the patients. Furthermore, the effect of non-quantified benefits should also be considered.

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