Factors influencing direct clinical costs of outpatient arthroscopic rotator cuff repair surgery

Tashjian, Robert Z.; Belisle, Jeffrey; Baran, Sean; Nelson, Richard E.; Burks, Robert T.; Greis, Patrick E.

doi:10.1016/j.jse.2017.07.011

Cited by 35 publications

(31 citation statements)

References 13 publications

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“…Anchor number remains an important factor in surgical cost. 8 The previously described technique achieves a similar biomechanical construct with one-half the number of anchors, potentially decreasing direct costs of surgery. 2 Additionally, because no anchors are placed in medial row tunnels, footprint vascularization may be improved by allowing access of marrow elements to the bone tendon interface.…”

Section: Discussionmentioning

confidence: 99%

Rotator Cuff Repair Technique With Transosseous Knotless Anchor System

Murphy

Tashjian

Burks

2018

Arthroscopy Techniques

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Various surgical techniques exist for rotator cuff repair that provide a suitable environment for tendon–bone healing. Arthroscopic recreation of transosseous repairs, which had previously been performed by open or miniopen techniques, can now be performed; however, arthroscopic, transosseous passage of suture material can be challenging technically. There are potential biologic and cost-saving advantages of arthroscopic transosseous rotator cuff repair that make an efficient and reproducible technique desirable for arthroscopists. The technique for arthroscopic transosseous rotator cuff repair using a knotless anchor-based system is demonstrated in the current Technical Note. Potential advantages of this construct include excellent biomechanics, enhanced footprint vascularization, and utility in poor bone quality while using minimal anchor numbers. Further studies will be needed to elucidate healing rates and clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Rotator Cuff Repair Technique With Transosseous Knotless Anchor System

Murphy

Tashjian

Burks

2018

Arthroscopy Techniques

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“…VDO costing methods have been previously described, yielding total direct costs for materials used for patient care, facility utilization direct costs (including sterile processing costs), and time-based cost allocations including procedure/operative time and cost of staff involved in care (nursing, surgical technicians, medical assistants). 1,25,26 Total direct cost categories, as tabulated by the VDO tool, are further described in ►Appendix A. All reported cost data were normalized using each individual's cost divided by the average cost in the data set, to comply with institutional guidelines prohibiting the public reporting of any financial data related to the details of nonpublically disclosed contractual agreements, or raw cost data.…”

Section: Methodsmentioning

confidence: 99%

“…This has successfully identified areas of high variability in cost, leading to improved value of care delivered. 1,25,26 In this study, the VDO tool was utilized to answer our primary study question of whether surgical costs differ between PRC and FCA. Similarly, our second study question, whether surgical costs differ based on the type of fixation used for FCA (headless compression screws, plate/screw construct, or staples), was investigated.…”

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confidence: 99%

Comparison of Direct Surgical Costs for Proximal Row Carpectomy and Four-Corner Arthrodesis

et al. 2018

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Background Proximal row carpectomy (PRC) and four-corner arthrodesis (FCA) are common treatments for stage II scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) wrists, with similar functional and patient-reported outcomes reported in the peer-reviewed literature. Questions Study questions included (1) whether surgical encounter total direct costs (SETDCs) differ between PRC and FCA, and (2) whether SETDC differs by method of fixation for FCA. Patients and Methods Consecutive adult patients (≥ 18 years) undergoing PRC and FCA between July 2011 and May 2017 at a single tertiary care academic institution were identified. Patients undergoing additional simultaneous procedures were excluded. Using our institution's information technology value tools, we extracted prospectively collected cost data for each surgical encounter. SETDCs were compared between PRC and FCA, and between FCA subgroups (screws, plating, or staples). Results Of 42 included patients, mean age was similar between the 23 PRC and 19 FCA patients (51.2 vs. 54.5 years, respectively). SETDCs were significantly greater for FCA than PRC by 425%. FCA involved significantly greater facility costs (2.3-fold), supply costs (10-fold), and operative time (121 vs. 57 minutes). Implant costs were absent for PRC, which were responsible for 55% of the SETDC for FCA. Compared with compression screws, plating and staple fixation were significantly more costly (70% and 240% greater, respectively). Conclusion SETDCs were 425% greater for FCA than PRC. Implant costs for FCA alone were 130% greater than the entire surgical encounter for PRC. For FCA, SETDC varied depending on the method of fixation. Level of Evidence This is a level III, cost analysis study.

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“…In 2018, Tashjian et al 3 examined the factors that influence the direct clinical cost of arthroscopic rotator cuff repair. They found that higher direct costs were associated with subscapularis repair, as well as biceps tenodesis with anchors, and the total number of anchors used influenced the direct cost.…”

Section: See Related Article On Page 2354mentioning

confidence: 99%

Editorial Commentary: Stagnant Surgeon Reimbursement Since 2005 Does Not Reflect the Current Complexity of Arthroscopic Rotator Cuff Repair in 2020

Gamradt

2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Factors influencing direct clinical costs of outpatient arthroscopic rotator cuff repair surgery

Cited by 35 publications

References 13 publications

Rotator Cuff Repair Technique With Transosseous Knotless Anchor System

Rotator Cuff Repair Technique With Transosseous Knotless Anchor System

Comparison of Direct Surgical Costs for Proximal Row Carpectomy and Four-Corner Arthrodesis

Editorial Commentary: Stagnant Surgeon Reimbursement Since 2005 Does Not Reflect the Current Complexity of Arthroscopic Rotator Cuff Repair in 2020

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