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[Comparison of surgical techniques for rotator cuff injury: cost-result]
R Velasco-Alcázar1, M C Rojas-Sosa2, M G Navarro-López3
1Servicio de Extremidad Torácica, Hospital General Regional No. 2 «Villa Coapa», Instituto Mexicano del Seguro Social (IMSS). Ciudad de México. México.
Introduction:
Currently, to manage rotator cuff injury (RCI), there is a tendency to replace mini-open (MO) surgery with arthroscopy, but results and costs are controversial.
Objective:
To analyze the cost-result of surgical techniques for RCI.
Material And Methods:
A partial economic evaluation of cost-result type was performed on 113 patients with RCI surgically operated by mini-open technique (n = 6), or arthroscopy (n = 91), or both (n = 16). Direct costs included: hospital stay, days of work disability, surgery, implants (anchors), medical assessments, laboratory and imaging. One-year shoulder functionality was evaluated with Constant-Murley scale (EscC-M).
Results:
The MO technique was the most economical (X = $42,950.60 MXN) and the most expensive was the arthroscopy + MO with anchors (X = $89,594.80 MXN); with a non-significant difference in shoulder functionality (EscC-M = 56.33 ± 7.0 vs. 64.25 ± 9.0 points, respectively) (p 0.05; Kruskal-Wallis; post hoc Mann-Whitney). Difference of $46,644.1 MXN between techniques corresponded to 7.92 points. There was a mild relationship between the technique and the functionality of shoulder (rs = 0.26; p = 0.005; Spearman).
Conclusion:
The mini-open technique showed best cost-result, with similar functionality in shoulder to that obtained with the more expensive technique.
