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Cost Analysis in Shoulder Surgery: A Systematic Review.

Thomas Tischer1, Robert Lenz1, Jochen Breinlinger-O'Reilly2

  • 1Department of Orthopaedic Surgery, University Medicine Rostock, Rostock, Germany.

Orthopaedic Journal of Sports Medicine
|May 22, 2020
PubMed
Summary

Cost-effectiveness analyses in shoulder surgery are improving in quality. Recent studies suggest arthroscopic rotator cuff repair is cost-effective, while platelet-rich plasma augmentation may not be.

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Area of Science:

  • Orthopedic Surgery
  • Health Economics
  • Medical Technology Assessment

Background:

  • Cost analysis studies in medicine are gaining importance due to rising financial considerations.
  • Efficient resource allocation is crucial in modern healthcare.

Purpose of the Study:

  • To systematically review the current state of cost-effectiveness analyses in shoulder surgery.
  • To assess the quality and findings of economic evaluations in this field.

Main Methods:

  • Systematic review following PRISMA guidelines.
  • Inclusion of full economic analyses published since January 1, 2010, using terms 'cost analysis' and 'shoulder'.
  • Assessment of methodological quality using Oxford CEBM levels and QHES instrument.
Keywords:
cost-effectivenesseconomic evaluationinstabilityrotator cuff

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Main Results:

  • 34 studies met inclusion criteria; recent studies show improved quality (Level 1 and 2 evidence).
  • Rotator cuff tears were the most studied condition (13 studies).
  • Key findings include MRI as cost-effective imaging, arthroscopic rotator cuff repair (RCR) with conversion as optimal, PRP augmentation of RCR likely not cost-effective, and unclear cost-effectiveness of double-row RCR.

Conclusions:

  • The quality of cost-effectiveness studies in shoulder surgery has significantly improved.
  • Current evidence can aid decision-makers in resource allocation for better patient care.
  • Further research is needed to optimize financial resource utilization in shoulder surgery.