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Berger A, Bozic K, Stacey B et al. Arthritis Rheum 2011;63:2268–75.

Berger et al. used a large US health insurance claims database to determine pharmacotherapy and healthcare utilization, and their associated costs, during the 2 years prior to total knee replacement or total hip replacement in osteoarthritis patients. Relatively high levels of medication and healthcare utilization were identified in these patients during this time-period. Healthcare costs were also high, and increased as the time of surgery approached.


Osteoarthritis (OA) occurs in 27 million patients in the US aged >25 years. It is the most common human joint disease and the main cause of disability in older persons. Arthroplastic surgery such as total knee replacement (TKR) and total hip replacement (THR) usually restore function and improve quality of life in patients with OA, but these interventions are normally reserved for patients with loss of function and increasing pain intensity in spite of the use of non-operative treatments (e.g. medications, physical therapy, exercise, activity modifications, and weight loss). OA is the main reason for THR and TKR, which are performed 500 000 (THR) and 700 000 (TKR) times annually in the US. This study was undertaken to evaluate the utilization of pharmacotherapy and healthcare services, and the associated costs, among OA patients over a 24-month period preceding TKR or THR.

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