Double-Row Arthroscopic Rotator Cuff Repair Is More Cost-Effective Than Single-Row Repair

Huang, Adrian; Thavorn, Kednapa; Katwyk, Sasha van; MacDonald, Peter B.; Lapner, Peter

doi:10.2106/jbjs.16.01044

Cited by 32 publications

(22 citation statements)

References 20 publications

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“…Cost analysis on surgical techniques in arthroscopic RCR also revealed varying results. While Genuario et al 16 reported in their analysis on the cost-effectiveness of single-row RCR versus double-row RCR that double-row RCR was not cost-effective for any sized RCTs, Huang et al 23 found double-row RCR to be more cost-effective than single-row RCR in some cases, especially in larger RCTs. This discrepancy most likely results from the varying underlying costs of surgery that were used for calculations, depending on the health care system.…”

Section: Discussionmentioning

confidence: 98%

Cost Analysis in Shoulder Surgery: A Systematic Review

Tischer

Lenz

Breinlinger-O'Reilly

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Cost analysis studies in medicine were uncommon in the past, but with the rising importance of financial considerations, it has become increasingly important to use available resources most efficiently. Purpose: To analyze the current state of cost-effectiveness analyses in shoulder surgery. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of the current literature was performed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. All full economic analyses published since January 1, 2010 and including the terms “cost analysis” and “shoulder” were checked for usability. The methodological quality of the studies was assessed using the Oxford Centre for Evidence-Based Medicine levels of evidence and established health economic criteria (Quality of Health Economic Studies [QHES] instrument). Results: A total of 34 studies fulfilled the inclusion criteria. Compared with older studies, recent studies were of better quality: one level 1 study and eight level 2 studies were included. The mean QHES score was 87 of 100. The thematic focus of most studies (n = 13) was rotator cuff tears, with the main findings as follows: (1) magnetic resonance imaging is a cost-effective imaging strategy, (2) primary (arthroscopic) rotator cuff repair (RCR) with conversion to reverse total shoulder arthroplasty in case of failure is the most cost-effective strategy, (3) the platelet-rich plasma augmentation of RCR seems not to be cost-effective, and (4) the cost-effectiveness of double-row RCR remains unclear. Other studies included shoulder instability (n = 3), glenohumeral osteoarthritis (n = 3), proximal humeral fractures (n = 4), subacromial impingement (n = 4), and other shoulder conditions (n = 7). Conclusion: Compared with prior studies, the quality of recently available studies has improved significantly. Current studies could help decision makers to appropriately and adequately allocate resources. The optimal use of financial resources will be of increasing importance to improve medical care for patients. However, further studies are still necessary.

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Section: Discussionmentioning

confidence: 98%

Cost Analysis in Shoulder Surgery: A Systematic Review

Tischer

Lenz

Breinlinger-O'Reilly

et al. 2020

Orthopaedic Journal of Sports Medicine

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“…On the other hand, a later cost-utility analysis by Huang et al [67], indicated that even though there were no significant differences in functional or qualityof-life measures between single row and double row repair technique, double row repair was more cost effective than SR. There was also noted that DR fixation was more economically friendly for tear larger than 3 cm.…”

Section: Costmentioning

confidence: 98%

Single-Row Versus Double-Row Repair in Rotator Cuff Tears

Hantes¹,

Chalatsis²,

Mpakagiannis³

2020

Surgical Recovery

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Rotator cuff (RC) tear is a common cause of shoulder pain and disability among adults. Surgical management of RC tears is recommended after conservative treatment failure. Due to the development of arthroscopic repair techniques, the use of the arthroscopic rotator cuff repair has become the gold standard. Singlerow (SR) and double-row (DR) suture anchor repairs are the two most popular and commonly used arthroscopic techniques. However, the optimal arthroscopic surgical technique remains controversial in terms of clinical and biomechanical outcomes, healing, and re-tear rates. This chapter will focus on differences between these two techniques regarding biomechanics, clinical results, healing rate, and cost effectiveness.

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“…The cost-effectiveness of rotator cuff repair may be affected by the relative risk of retear rates because revision surgery for retear carries an additional cost burden. 6 Bisson calculated the costs to the US healthcare system to transition from the single row to the suture bridge technique and found that large decreases in revision rates would be necessary to justify the added cost. 7 Brown et al performed a meta-analysis to evaluate suture configuration, repair method and tear size on retear rates and found that the suture technique may not affect rerupture rates after rotator cuff repair.…”

Section: Limitationsmentioning

confidence: 99%