Cost comparison of anterior cruciate ligament reconstruction: autograft versus allograft.
OBJECTIVE
To compare the economic costs associated with anterior cruciate ligament (ACL) reconstruction using either autograft or allograft. The surgical costs are reported, including charge categories, for each procedure. All operations were performed in the Southern United States of America.


METHODS
Evaluation of cost data collected from a group of patients participating in a prospective, nonrandomized trial.


METHODS
A total of 122 patients with ACL-deficient knees undergoing surgical reconstruction using either bone-patellar tendon-bone autograft (n = 86) or freeze-dried Achilles tendon allograft (n = 37) were analyzed (1 patient underwent 2 allograft reconstructions). Patient selection for groups was based on the physician performing the surgery (2 surgeons performed autografts and 1 performed allografts). Groups were compared with respect to age, sex, race, and occupation. Hospital charge data were retrieved from the billing department and divided into various categories for comparison of the 2 groups.


RESULTS
The mean hospital charge for ACL reconstruction was 4,622 dollars for allograft and 5,694 dollars for autograft (P < .0001). Differences included increased operating room time and a greater likelihood of overnight hospitalization for autograft procedures. This was slightly offset by higher charges for operating room supplies for allograft reconstructions owing to the cost of the graft itself.


CONCLUSIONS
Allograft reconstruction of the ACL was significantly less expensive than autograft bone-patellar tendon-bone reconstruction. Allograft ACL reconstruction is a less costly alternative to autograft reconstruction.


METHODS
Level IV, economic analysis with no sensitivity analysis.
Cole
David W
DW
Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1070, USA. dcole@wfubmc.edu
Ginn
T Adam
TA
Chen
G John
GJ
Smith
Beth P
BP
Curl
Walton W
WW
Martin
David F
DF
Poehling
Gary G
GG
D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D001182:Arthroscopy / Q000191:economics / Q000379:methods; D001842:Bone and Bones / Q000601:surgery; D003365:Costs and Cost Analysis; D004469:Economics, Hospital; D005260:Female; D006801:Humans; D008297:Male; D010329:Patella / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000191:economics*; D012189:Retrospective Studies; D014182:Transplantation, Autologous / Q000191:economics; D014184:Transplantation, Homologous / Q000191:economics; D014481:United States