ACL reconstruction: patellar tendon versus hamstring grafts--economical aspects

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Health Economics

Background:

• A recent trend shows increased use of hamstring tendons over patellar tendons for anterior cruciate ligament (ACL) reconstruction in Sweden.
• This shift necessitates a cost-effectiveness analysis of graft choices.

Purpose of the Study:

• To compare the economic costs associated with using patellar tendon versus hamstring tendons for ACL reconstruction.
• To evaluate the influence of different fixation methods on the overall cost.

Main Methods:

• A retrospective analysis of 440 primary ACL reconstructions performed in 2004.
• Data collection included graft type (patellar tendon vs. hamstring tendon), surgical time, fixation methods, and associated costs.
• Statistical analysis was performed to compare costs and surgical durations.

Main Results:

• Hamstring grafts were used in 78.4% of cases, while patellar tendon grafts were used in 21.6%.
• Patellar tendon reconstruction averaged 197 euros, significantly less than hamstring reconstruction at 436 euros.
• Surgery time for patellar tendon grafts was 11.5 minutes shorter on average than for hamstring grafts, contributing to a cost difference of 90 euros.
• The total additional cost for hamstring grafts, including fixation and surgery time, was approximately 329 euros more than for patellar tendon grafts.

Conclusions:

• From a purely economic perspective, the patellar tendon is a more cost-effective graft choice for ACL reconstruction.
• The findings suggest reconsidering the increased preference for hamstring tendons in ACL reconstruction based on cost-efficiency.