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Is Arthroscopic Latarjet a Cost-Effective Procedure? A Decision Analysis
The Archives of Bone and Joint Surgery
|February 6, 2024
Summary
Arthroscopic Latarjet surgery for shoulder instability is more expensive than the open approach with similar patient outcomes. Further evidence is needed to justify the higher cost of the arthroscopic technique.
Area of Science:
- Orthopedic Surgery
- Health Economics
Background:
- Arthroscopic Latarjet is an alternative to open Latarjet for glenohumeral stabilization.
- Evidence is mixed regarding the improved outcomes of the arthroscopic technique.
Purpose of the Study:
- To assess the cost and utility of arthroscopic versus open Latarjet procedures.
- To determine the cost-effectiveness of Latarjet stabilization over a ten-year period.
Main Methods:
- A cost-effectiveness model was developed over ten years.
- Institutional data on equipment utilization and ambulatory surgical center costs were analyzed.
- Utility scores were derived using the EuroQol (EQ) 5D, and decision-tree analysis was performed.
Main Results:
- Arthroscopic Latarjet costs $2,796.87 more than open Latarjet.
- Utility scores were nearly identical: 1.330 for arthroscopic and 1.338 for open Latarjet.
- For cost equivalence, arthroscopic surgery time must be reduced to 41.5 minutes or equipment costs eliminated.
Conclusions:
- The higher cost of arthroscopic Latarjet is not supported by current cost and utility data.
- Open Latarjet demonstrates slightly better utility.
- Additional benefits of the arthroscopic approach, such as reduced narcotic use or complications, must be proven to justify its cost.
