Costs of open, arthroscopic and combined surgery for developmental dysplasia of the hip

Area of Science:

• Orthopedic surgery
• Health economics
• Medical technology assessment

Background:

• Developmental dysplasia of the hip (DDH) management has various surgical options.
• Clinical outcomes for DDH treatments are well-documented.
• Comparative cost-effectiveness data for DDH management techniques are lacking.

Purpose of the Study:

• To evaluate and compare in-hospital costs for different management strategies in patients with DDH.
• To analyze the cost implications of periacetabular osteotomy (PAO), hip arthroscopy (HA), and combined PAO + HA procedures.
• To provide economic data complementing existing clinical outcome reports for DDH.

Main Methods:

• Retrospective analysis of 109 patients diagnosed with DDH.
• Categorization into three treatment groups: PAO + HA (35 patients), PAO (32 patients), and HA (42 patients).
• Calculation and adjustment of total direct medical costs to 2017 inflation-adjusted dollars using nationally representative unit costs.

Main Results:

• Significant differences in total in-hospital costs were observed across the three groups.
• PAO + HA incurred the highest median cost ($21,852), followed by PAO ($15,124), and HA ($11,582).
• Outpatient procedures ($11,385) were significantly less expensive than inpatient procedures ($24,320); inpatient HA costs became comparable to PAO and PAO + HA.

Conclusions:

• Surgical complexity directly correlates with increased healthcare costs in DDH management.
• The cost-effectiveness of HA can be significantly impacted by inpatient versus outpatient status.
• These cost findings are crucial for surgeons and policymakers seeking to optimize value in DDH patient care.