{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T07:15:07Z","timestamp":1788333307644,"version":"build-2803163510"},"reference-count":76,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["arthroscopyjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To perform comparative cost\u2010effectiveness assessments through 30\u2010year follow\u2010up after multisurface osteochondral allograft transplantation (mOCAT), unicompartmental knee arthroplasty (UKA), or total knee arthroplasty (TKA) in a theoretical cohort of middle\u2010aged patients with symptomatic complex articular disorders in the knee.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A Markov cohort model was designed and used to evaluate the comparative cost\u2010effectiveness of mOCAT, UKA, and TKA over a 30\u2010year follow\u2010up period in a theoretical patient population of active 40\u2010year\u2010olds based on quality\u2010adjusted life year, incremental cost\u2010effectiveness ratio, and willingness\u2010to\u2010pay analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among all surgical procedures analyzed, mOCAT was associated with the highest costs ($111,721 at 30\u2009years), whereas UKA was associated with the lowest costs ($31,072 at 30\u2009years). UKA was determined to be the most cost\u2010effective of all procedures analyzed when comparing direct costs based on incremental cost\u2010effectiveness ratio using a willingness\u2010to\u2010pay threshold of $50,000. Despite the relatively high direct costs, optimized mOCAT yielded the greatest benefits relative to TKA with respect to cumulative quality\u2010adjusted life year differences throughout the study period modeled, indicating a sustained and clinically meaningful benefit. In addition, optimized mOCAT showed a clinically meaningful improvement over UKA in exceeding the cumulative minimal clinically important difference threshold, but only during the first 10\u2009years after surgery. Sex\u2010stratified analyses showed minor differences in incremental cost\u2010effectiveness ratio estimates between men and women, but the overall cost\u2010effectiveness conclusions remained unchanged.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The results of this study provide computational data in support of optimized mOCAT and UKA being associated with potential advantages in direct comparative cost\u2010effectiveness over TKA in a 30\u2010year economic analysis model for a theoretical population of active middle\u2010aged patients with complex articular disorders of the knee.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, economic analysis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/arj.70495","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T06:44:15Z","timestamp":1788331455000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Optimized Multisurface Osteochondral Allograft Transplantation and Unicompartmental Knee Arthroplasty Are Associated With Potential Advantages in Direct Comparative Cost\u2010Effectiveness Over Total Knee Arthroplasty in a 30\u2010Year Economic Analysis Model of Active Middle\u2010Aged Patients With Complex Articular Disorders of the Knee"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6656-2896","authenticated-orcid":false,"given":"Jinpu","family":"Li","sequence":"first","affiliation":[{"name":"Thompson Laboratory for Regenerative Orthopaedics Missouri Orthopaedic Institute University of Missouri  Columbia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8627-1500","authenticated-orcid":false,"given":"Kylee","family":"Rucinski","sequence":"additional","affiliation":[{"name":"Thompson Laboratory for Regenerative Orthopaedics Missouri Orthopaedic Institute University of Missouri  Columbia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8467-6494","authenticated-orcid":false,"given":"James P.","family":"Stannard","sequence":"additional","affiliation":[{"name":"Thompson Laboratory for Regenerative Orthopaedics Missouri Orthopaedic Institute University of Missouri  Columbia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4859-224X","authenticated-orcid":false,"given":"Clayton W.","family":"Nuelle","sequence":"additional","affiliation":[{"name":"Thompson Laboratory for Regenerative Orthopaedics Missouri Orthopaedic Institute University of Missouri  Columbia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0862-995X","authenticated-orcid":false,"given":"James L.","family":"Cook","sequence":"additional","affiliation":[{"name":"Thompson Laboratory for Regenerative Orthopaedics Missouri Orthopaedic Institute University of Missouri  Columbia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1177\/0363546519834557","article-title":"Cost\u2010efficacy of knee cartilage defect treatments in the United States","volume":"48","author":"Everhart JS","year":"2020","journal-title":"Am J Sports Med."},{"key":"e_1_2_8_3_1","doi-asserted-by":"crossref","first-page":"2175","DOI":"10.1177\/0363546515591261","article-title":"Microfracture and osteochondral autograft transplantation are cost\u2010effective 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