A Cost and Healthcare Utilization Analysis of Minimally-Invasive Alveolar Bone Grafting Techniques Compared With Open...

Multiple approaches exist for autologous alveolar bone grafting (ABG), including open iliac crest harvesting and minimally invasive techniques such as the Acumed power trephine. These vary in their degree of invasiveness, cost, and postoperative admission course. This study aimed to assess the financial implications of the traditional versus the Acumed approach for patients, surgeons, and institutions as part of care planning.

A single-site retrospective matched pairs cohort study including all cleft palate (CP) and cleft lip and/or palate (CLP) patients undergoing ABG between January 2015 and December 2024.

Length of stay, anesthesia time, procedure time, PACU time, supply costs, implant costs, medication cost, and total cost.

Length of stay was shortest for Acumed, with a median time of 7 hours, compared with open iliac crest harvesting at 25 hours, which was statistically significant. Anesthesia time for Acumed (137.6 min) was similarly significantly less than that of the open group (271.3 min). Acumed also had a statistically significantly shorter procedure time of 68 minutes when compared with 154 minutes in the open group. Supply costs were significantly greater for Acumed ($623 versus $303). However, total accrued hospital costs were significantly higher for patients who underwent the open approach ($40,500 versus $27,993).

The Acumed bone graft harvesting technique can reduce the financial burden on patients and hospitals compared with open techniques by primarily decreasing length of stay, despite higher equipment costs.