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Similar cost-utility for double- and single-bundle techniques in ACL reconstruction.

N Sernert1,2, E Hansson3,4

  • 1Department of Research and Development, NU Hospital Group, Trollhättan, Sweden. ninni.sernert@vgregion.se.

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
|September 24, 2017
PubMed
Summary

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The double-bundle (DB) technique for ACL reconstruction is more expensive than the single-bundle (SB) technique, with no significant difference in quality-adjusted life years (QALYs). Individualized treatment may be preferred.

Area of Science:

  • Orthopedic surgery
  • Health economics
  • Clinical outcomes research

Background:

  • Anterior cruciate ligament (ACL) reconstruction is a common orthopedic procedure.
  • The choice between single-bundle (SB) and double-bundle (DB) techniques impacts surgical complexity and resource utilization.
  • Understanding the cost-utility of different surgical techniques is crucial for healthcare decision-making.

Purpose of the Study:

  • To compare the cost-utility of the double-bundle (DB) versus the single-bundle (SB) technique for ACL reconstruction.
  • To evaluate outcomes 2 years after surgery.

Main Methods:

  • A randomized controlled trial comparing DB (n=53) and SB (n=50) ACL reconstruction techniques.
  • Cost-utility analysis using quality-adjusted life years (QALYs) as the primary outcome.
Keywords:
ACL injuryHRQoLICERQALYSensitivity analysesSingle- and double-bundle technique

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  • Inclusion of direct (healthcare) and indirect (work ability) costs.

    • Main Results:

    • No significant difference in QALYs gained between the DB and SB groups.
    • DB technique resulted in statistically significantly longer operating room times and higher direct costs.
    • Cost-effectiveness acceptability curve indicated a 50% probability of DB being cost-effective at a threshold of €50,000.

    Conclusions:

    • The DB technique is more expensive from a healthcare perspective compared to the SB technique.
    • Clinical outcomes were comparable between the two techniques.
    • Physician choice of technique may be individualized based on patient expectations and requirements.