Cost Mitigation Using Implant-Minimizing Techniques in Multiligamentous Injuries of Knee

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering

Background:

• Knee preservation surgeries, including ligament reconstructions, are increasing, leading to higher healthcare costs.
• Arthroscopic knee surgery faces challenges due to high costs and limited sophisticated options like allografts.

Purpose of the Study:

• To introduce and evaluate simple, implant-minimizing techniques (IMTs) for knee ligament reconstruction.
• To reduce the financial burden and implant/allograft usage in knee surgeries.

Main Methods:

• Developed four implant-minimizing techniques (IMTs): confluent tunnel, bone bridge, suture bridge, and cinch knot techniques.
• Applied IMTs for various knee ligament reconstructions, including ACL, PCL, LCL, MCL, and MPFL, often combined with meniscal repair.
• Analyzed the cost-effectiveness of IMTs compared to standard fixation methods.

Main Results:

• IMTs demonstrated a cost reduction of over 60% compared to standard fixation methods.
• Patients achieved good-to-excellent functional outcomes with no major complications.
• Techniques were effective in minimizing graft usage and preserving bone stock.

Conclusions:

• Implant-minimizing techniques (IMTs) offer a significant cost-effective solution for knee ligament reconstruction.
• These techniques reduce the need for implants and allografts, preserve bone, and avoid tunnel convergence, especially in smaller knees.
• IMTs are straightforward to implement without requiring specialized instrumentation.