A cost analysis of single-row versus double-row and suture bridge rotator cuff repair methods

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• 作者：Leslie Bisson ; Nikola Zivaljevic…
• 关键词：Rotator cuff repair ; Cost analysis ; Single row ; Double row ; Suture bridge
• 刊名：Knee Surgery, Sports Traumatology, Arthroscopy
• 出版年：2015
• 出版时间：February 2015
• 年：2015
• 卷：23
• 期：2
• 页码：487-493
• 全文大小：170 KB
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Orthopedics
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1433-7347

文摘

Purpose To calculate the costs to the US healthcare system of transition from single-row (SR) to double-row (DR) rotator cuff repair (RCR) and to calculate the decrease in re-operations for re-tear that DR RCR would need to accomplish in order to render the transition cost-neutral. Methods Standard accounting methods were used to determine the cost of a single RCR, the annual cost to the US healthcare system of rotator cuff surgery, the cost of a single-revision RCR, and the decrease in revision for re-tear rate necessary to make DR or suture bridge (SB) methods cost-neutral in comparison with SR methods. We varied tear size, operating room cost, time required for implant placement, annual tear size distribution, and repair method. Results The cost of RCR ranged from $7,572 (SR, 5?cm tear). Complete conversion from SR RCR to a DR technique without an associated decrease in revision surgeries would increase the annual US healthcare cost between $80 million and $262 million per year. To obtain cost neutrality, use of DR or SB methods would need to result in one fewer revision in every 17 primary repairs (for tears 5?cm). Conclusions Conversion from SR to DR or SB RCR techniques would result in considerable increases in healthcare expenditures. Since the large decreases in revision surgery rates necessary to justify DR or SB repairs purely on a cost basis may not be realistic or even possible, the use of these methods should be supported by evidence of improved structural healing rates and quality-adjusted life years in comparison with SR methods. Level of evidence IV.