Similar cost-utility for double- and single-bundle techniques in ACL reconstruction.
Knee Surg Sports Traumatol Arthrosc
; 26(2): 634-647, 2018 Feb.
Article
em En
| MEDLINE
| ID: mdl-28939947
ABSTRACT
PURPOSE:
The aim was to estimate the cost-utility of the DB technique (n = 53) compared with the SB (n = 50) technique 2 years after ACL reconstruction.METHODS:
One hundred and five patients with an ACL injury were randomised to either the Double-bundle (DB) or the Single-bundle (SB) technique. One hundred and three patients (SBG n = 50, DBG n = 53) attended the 2-year follow-up examination. The mean age was 27.5 (8.4) years in the SBG and 30.1 (9.1) years in the DBG. The cost per quality-adjusted life years (QALYs) was used as the primary outcome. Direct costs were the cost of health care, in this case outpatient procedures. Indirect costs are costs related to reduce work ability for health reasons. The cost-utility analysis was measured in terms of QALY gained.RESULTS:
The groups were comparable in terms of clinical outcome. Operating room time was statistically significantly longer in the DBG (p = 0.001), making the direct costs statistically significantly higher in the DBG (p = 0.005). There was no significant difference in QALYs between groups. In the cost-effectiveness plane, the mean difference in costs and QALYs from the trial data using 1000 bootstrap replicates in order to visualise the uncertainty associated with the mean incremental cost-effectiveness ratio (ICER) estimate showed that the ICERs were spread out over all quadrants. The cost-effectiveness acceptability curve showed that there was a 50% probability of the DB being cost-effective at a threshold of Euro 50,000.CONCLUSION:
The principal findings are that the DB is more expensive from a health-care perspective. This suggests that the physician may choose individualised treatment to match the patients' expectations and requirements.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Análise Custo-Benefício
/
Reconstrução do Ligamento Cruzado Anterior
/
Lesões do Ligamento Cruzado Anterior
Tipo de estudo:
Clinical_trials
/
Health_economic_evaluation
Limite:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Knee Surg Sports Traumatol Arthrosc
Assunto da revista:
MEDICINA ESPORTIVA
/
TRAUMATOLOGIA
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Suécia