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TKA was more cost-effective compared to non-operative management regardless of specific patient variables. The analyses of the CEAs included in the study have to be interpreted with caution. Overall, certain surgical methods within TKA and alternative methods to TKA appear to be favoured for treating particular knee osteoarthritic conditions due to their suggested greater cost-effectiveness but this should be interpreted within local contexts. Our results should help guide future policy-making as healthcare associated costs continue to