hta_ knee intro.qxp - Ministero della Salute

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14 Table 5.2: Responding centres Region Responders Source: analysis by Agenas on returned questionnaires. Key: P.A. = Autonomous Province (i.e. regional equivalent) Responding centres/ total regional sample Responding centres/ total national sample Piemonte 5 55.56% 7.58% Valle d'Aosta 0 0.00% 0.00% Lombardia 11 57.89% 16.67% P.A. Bolzano 2 50.00% 3.03% P.A. Trento 0 0.00% 0.00% Veneto 7 87.50% 10.61% Friuli Venezia Giulia 0 0.00% 0.00% Liguria 4 100.00% 6.06% Emilia Romagna 6 60.00% 9.09% Toscana 4 44.44% 6.06% Umbria 1 25.00% 1.52% Marche 3 60.00% 4.55% Lazio 5 38.46% 7.58% Abruzzo 1 16.67% 1.52% Molise 1 33.33% 1.52% Campania 5 45.45% 7.58% Puglia 3 37.50% 4.55% Basilicata 1 33.33% 1.52% Calabria 1 16.67% 1.52% Sicilia 4 28.57% 6.06% Sardegna 2 40.00% 3.03% Total 66 44.90% 100.00%
Figure 5.2: Percentage of responding by type of INHS centres (total = 66 responding centres) Source: analysis by Agenas on returned questionnaires 5.2.3 Number of procedures performed We extracted data on volume of activity for 2006 from hospital discharge records whilst 2007 data came from the questionnaires. The volume of activity within the 66 responding centres was 4.956 procedures during 2006 for total knee replacement (40% of the total of procedures performed by the entire sample of 142 centres). The 2007 volume of activity was incomplete due to a percentage of missing data. Within responding centres the number of procedures performed was 4,345 primary TKRs and 259 revisions. 10 centres omitted data for primary TKR and 20 centres omitted data for revision. Figures 5.3 and 5.4 show the number (by region) of procedures performed by responding centres during 2006-2007. Procedure data are only calculated for the centres for which we had the number of procedures for both 2006 and 2007. There were no substantial differences between 2006 and 2007 in the number of procedures performed for TKR, while revision data show some differences for two Italian regions but the national trend is similar for both 2006 and 2007. 5.2.4 Types of prostheses used The 66 responding centres purchased 39 different models of knee prosthesis for 2006 and 2007. NEXGEN (ZIMMER) was the most widely used and purchased knee system (more than 800 systems were purchased in 2006 and more than 1,000 in 2007). The list of knee systems, number of providers and relative purchased volume, by responding centres (in 2006 and 2007), are presented in Tables 5.3 and 5.4. There are no substantial differences in terms of utilisation, volume and purchasers, between 2006 and 2007, and no difference between public and private accredited providers. Based on our observations from 66 responding centres it appears that a restricted number of prostheses (NEXGEN, SCORPIO, PROFIX, GENESIS II, LCS, VANGUARD) account for the bulk of the market with NEXGEN being the most purchased and geographically the most popular prosthesis. At the other end of the scale a large number of prostheses are rarely bought and restricted in their geographical spread. 15
Page 1 and 2: HTA REPORT Prostheses for primary t
Page 3 and 4: Contributions Authors Marina Cerbo,
Page 5 and 6: HTA REPORT Prostheses for primary t
Page 7 and 8: 10. Recommendations . . . . . . . .
Page 9: Prefazione Quest’anno l’Agenas
Page 12 and 13: XII Results Literature in this fiel
Page 14 and 15: XIV Obiettivi del report L’interv
Page 16 and 17: XVI formati e delle variabili racco
Page 18 and 19: 2 The procedures were identified ac
Page 21 and 22: 2. Technology, procedure and altern
Page 23: 3. The marketing status of knee pro
Page 27 and 28: 5. Context-specific analysis Contex
Page 29: Figure 5.1: Type of centres in the
Page 33 and 34: Table 5.3: Volume of purchased pros
Page 35 and 36: 5.2.5 Analysis on purchasing price
Page 37: Table 5.6: Distribution of mean wei
Page 40 and 41: 24 6.1.3 Evidence synthesis After t
Page 42 and 43: 26 Survival rate as “revision for
Page 44: 28 Table 6.1: Evidence table for si
Page 49 and 50: 7. Assessing the evidence from arth
Page 51 and 52: Only four reports out of the 9 repo
Page 53 and 54: Table 7.3: Variables used in each r
Page 55 and 56: Table 7.4: Replies from the key-per
Page 57 and 58: Table 7.6: Data from the Australian
Page 59 and 60: Table 7.8: Data from Registro dell
Page 61 and 62: Table 7.11: Data from the Australia
Page 63 and 64: Table 7.15: Data from Registro dell
Page 65: Table 7.18: Revision rates of uncem
Page 68 and 69: 52 We calculated ICERs only for cla
Page 70 and 71: 54 Figure 8.1 shows prostheses ICER
Page 72 and 73: 56 Table 8.3: ICER (AOAJRR data) fo
Page 74 and 75: 58 8.4 Conclusions Regardless of wh
Page 76 and 77: 60 The gross heterogeneity of repor
Page 79: 10. Recommendations We recommend th
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12. Competing interests declaration
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70 22. http://www.agenas.it/monitor
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72 • a tibial component: a metall
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74 Retention or sacrifice of the po
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76 Figure A1.2: Examples of femoral
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78 Suggested readings Bronzino JD.
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Appendix 2 Survey of Medical device
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Appendix 3 Sampling methodology The
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Table A2.2: Sample and total centre
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92 Veneto: 050017 Ospedale Sacro Cu
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94 Basilicata: 170011 Presidio Ospe
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Appendix 6 Search strategy The sear
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#50. (hls AND noetos) AND tornier A
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#108. (prime) AND (exatech) AND pri
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#166. (vanguard AND ps) AND ('biome
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Select 6 document(s) Search ("1998-
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Search ("1998-01-01"[Publication Da
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Appendix 7 Data extraction form for
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Common characteristics: Manufacture
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Conclusions: Assessment of generali
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Appendix 8 Data extraction form for
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Appendix 9 Quality assessment tool
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Appendix 10 List of excluded studie
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Studies excluded for short follow-u
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Robinson RP. Five-year follow-up of
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Regnér L, Carlsson L, Kärrholm J,
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Appendix 11 List of included studie
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Acronyms and abbreviations Agenas A
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