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Similar cost-utility for double- and single-bundle techniques in ACL reconstruction
1Department of Research and Development, NU Hospital Group, Trollhättan, Sweden. ninni.sernert@vgregion.se.
Summary
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.
- 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.
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