Abstract
Purpose
To calculate the cost of investigation of a painful Total Knee Replacement (TKR) to the hospital trust and Primary Care Trust (PCT).
Method
28 patients, over a year period, with painful Total Knee replacements were collected. Costs were calculated only of those patients who had an improvement in their symptoms such that they no longer had a painful TKR. The numbers of appointments, number of serological and radiological investigations were calculated along with any further investigations such as aspirations and arthroscopies. Costs were calculated from hospital records and charges to the PCT. An average cost per patient of investigations was calculated
Results
The patients (average age = 67.64) were investigated over an average of 22.93 months. During this time each patient had on average 4.07 orthopaedic appointments (total 114). The average number of blood tests performed per patient was 7.96 (total 223) along with 6.46 (total 181) X-rays performed.
The total spent on investigations for 28 patients, with a painful TKR, was £79809.56. The average cost of investigations per patient was £2850.34.
Conclusion
Costs for investigations for a patient with a painful TKR were high because of exceedingly high numbers of repeated investigations. A standardised protocol for the investigation of a painful TKR by a clinician would be beneficial to keep costs down. Early referral to a specialist in the field of painful TKR's is appropriate to allow timely and logical assessment and to avoid repeated investigations. This also allows earlier interventions with regards to revision surgery and also reduces the number of different appointments so reducing the financial workload implications
