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Consumer Prices for Surgical Management of Ankle Arthritis: Limited Availability and Wide Variability
Niall A Smyth1, Brody J Dawkins1, Joshua P Goldstein1
1Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, FL (Dr. Smyth); the Department of Orthopaedic Surgery, Medstar Union Memorial, Baltimore, MD (Dr. Schon); the Department of Orthopaedic Surgery, University of Miami Miller School of Medicine, Miami, FL (Mr. Dawkins, Mr. Goldstein, and Dr. Aiyer); and Hoag Orthopedic Institute, Irvine, CA (Dr. Kaplan).
Background:
Healthcare costs for the surgical management of ankle arthritis continue to rise. Patients are generally unaware of the prices of the services they use. Understanding the costs associated with surgical management of ankle arthritis is an important facet of patient care. The purposes of this study were to (1) determine the access to the surgical cost of total ankle arthroplasty (TAAs) and ankle arthrodesis and (2) the variability of the price between the two procedures.
Methods:
Fifty foot and ankle centers (25 academic, 25 private) that perform TAAs and ankle arthrodeses were contacted using a standardized patient script. The described patient was a 63-year-old man who had failed conservative treatment of ankle arthritis. Each institution was contacted up to three times in an attempt to obtain a full-bundled surgical quote for a TAA and an ankle arthrodesis.
Results:
Twenty-one centers (42%, 14 academic, 7 private) were able to provide a quote for a TAA and an ankle arthrodesis. The mean bundled price for a TAA was $50,332 (SD ± $25,744), with the mean academic and private center quote being $56,529 and $37,937, respectively. The mean bundled price for an ankle arthrodesis was $41,756 (SD ± $26,033), with the mean academic and private center quote being $48,116 and $29,037, respectively. No statistically significant difference was found between the bundled prices for TAA and ankle arthrodesis.
Discussion:
This study demonstrated limited availability of consumer prices for TAA and ankle arthrodesis. When comparing different institutions for surgical management of ankle arthritis, there was a wide range of quotes for both TAA and ankle arthrodesis. When comparing the choice of surgical management for ankle arthritis, no statistically significant difference was observed in price between TAA and ankle arthrodesis.
