Cost of Arthroscopic Rotator Cuff Repairs Is Primarily Driven by Procedure-Level Factors: A Single-Institution Analysis of an Ambulatory Surgery Center

Editorial Commentary: Cost Associated With Arthroscopic Rotator Cuff Repair Can Be Largely Controlled by the Surgeon

“…Patient factors affecting cost included race, sex, at least 1 comorbidity, income quartile, and Medicare insurance. The cost reported for a standard arthroscopic RCR in the study of Li et al 10 was more than 20% greater than identified by Morris et al 1 ($25,353 vs $19,728).…”

“…A similar study to that of Morris et al, 1 Li et al 10 used the 2014 State Ambulatory Surgery Database. In contrast to a single large-volume ASC, reviewing a multisite database created challenges, as the costs or charges from location to location or system to system may vary.…”

“…Orthopaedic surgeons will be pushed more toward value-based health care decision-making in the coming years. Value-based health care and cost-effectiveness analyses such as the one by Morris et al 1 assist orthopaedic surgeons in making ethical and fiscally responsible treatment choices for their patients. 11,12 The study by Morris et al 1 provides valuable information to fuel outcome optimization using a cost-conscious approach to RCRs.…”

Intrasubstance Patellar Tendon Repair with the Addition of a Bio-inductive Implant

“…The cost of the bio-inductive implants must be considered as the use of such an implant has been shown in the upper extremity literature to be more costly than performing a traditional repair technique, which we imagine would hold true with surgical repair of the patellar tendon. 16 Given that this is a new technique, rerupture rates have not been established, but studies have demonstrated that the use of these implants is safe and that they can promote new tendon formation months after surgery with some suggestions of improved healing rate. 15 , 17 Further studies are needed to investigate the long-term outcomes of patients with patellar tendon tears that are repaired using augmentation with bio-inductive implants.…”

The Transosseous Cerclage In Situ Technique for Biceps Tenodesis

“…Recently, subpectoral tenodesis has been shown to be an independent cost driver of arthroscopic shoulder procedures, in addition to suture anchors. 3 The subpectoral technique also has some disadvantages, such as the inability to accurately determine the length-tension relation of the tendon and a wound in the axilla, which is prone to dehiscence or infection, as well as fracture and/or musculocutaneous nerve injury from working in the subpectoral location. 4,5 Using the transosseous technique of arthroscopic suprapectoral tenodesis eliminates the additional cost of an open procedure, eliminates the cost and complications of hard implants, fixes the tendon in normal lengthtension alignment, eliminates the wound problem in the axilla, and provides similar outcomes in terms of pain relief.…”