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Computer-assisted navigation in ACL reconstruction is attractive but not yet cost efficient
Jennifer Margier1, Sandra David Tchouda, Jean-Jacques Banihachemi
1Cellule d'évaluation médico-économique des innovations, Pavillon Taillefer, CHU de Grenoble, 38043, Grenoble, France, jmargier@chu-grenoble.fr.
Summary
Computer-assisted navigation systems (CANSs) for anterior cruciate ligament (ACL) reconstruction show no clinical benefit over conventional surgery. While CANSs can reduce operating time for junior surgeons, they are not currently cost-effective from a hospital perspective.
Area of Science:
- Orthopedic surgery
- Medical technology assessment
- Health economics
Background:
- Conventional anterior cruciate ligament (ACL) reconstruction has high success rates.
- Computer-assisted navigation systems (CANSs) aim to enhance surgical accuracy.
- The economic impact of CANSs in ACL reconstruction requires evaluation.
Purpose of the Study:
- To assess the economic impact of computer-assisted navigation systems (CANSs) versus conventional surgery for ACL reconstruction from a hospital perspective.
- To compare the clinical effectiveness and costs associated with CANSs and conventional ACL reconstruction.
Main Methods:
- Prospective, multicenter, open-controlled study comparing CANSs and conventional ACL reconstruction.
- Included patients undergoing their first ACL reconstruction.
- Clinical efficacy assessed using the International Knee Documentation Committee score; costs collected retrospectively nationwide.
Main Results:
- No significant differences in clinical effectiveness between CANSs and conventional surgery.
- Junior surgeons showed a significant decrease in operating time with CANSs (30%) compared to conventional surgery (10%).
- CANS surgery was more expensive (1,158€) than conventional surgery (704€), with operating room costs dominating.
Conclusions:
- Computer-assisted navigation systems (CANSs) demonstrate feasibility and potential for training in ACL reconstruction.
- From a hospital economic perspective, CANSs are not currently cost-efficient for ACL reconstruction.
- Cost-effectiveness of CANSs may improve with increased surgeon expertise.
