Shoulder joint arthroplasty cost-effectiveness in the Czech Republic

The aim of this paper is to evaluate the cost-effectiveness of the shoulder joint arthroplasty in the Czech Republic. Cost-effectiveness of reverse total shoulder arthroplasty and hemiarthroplasty for traumatic three to four fragment luxation fractures of proximal part of humerus were assessed. For this diagnosis, both interventions can be used depending on the extent of the joint damage and regarding the overall health condition of the patient. Multi-criteria analysis for the clinical assessment of the effect (AHP, WSM) was conducted for both interventions. A four-stage hierarchical structure of criteria was proposed. Reverse total shoulder arthroplasty provides better outcomes than hemiarthroplasty in all considered criteria. Patients report less pain and better use of the arm in everyday life. According to the sensitivity analysis, a 50% rise in the price of the implant would switch the cost-effectiveness ratio in favour of the hemiarthroplasty.