[Cost analysis and economic impact of anterior cruciate ligament reconstruction].
BACKGROUND
Health economics studies play an important role in all healthcare systems. The purpose of the latter is to offer effective and low-cost treatments.


OBJECTIVE
Analyze the costs and the economic impact of the comprehensive ACL treatment.


METHODS
An average cost study was done of primary ACL reconstruction. We studied 104 patients during 2005, 79 males and 25 females, with mean age 31.5 years. The assessment of the preoperative, operative and postoperative costs was related to each patient's socioeconomic stratum (SES).


RESULTS
The hamstrings were the most frequently used graft (71%) versus the bone-patellar tendon-bone graft (BTB) (29%). Socioeconomic strata 2 and 3 were predominant. The following were the most frequent hamstrings implants used: Rigidfix/Intrafix and Endobutton/Xtralok, while the most frequent BTB grafts used were the metallic interference screws. No difference was found between the types of grafts and the SES in the preoperative and postoperative costs, including imaging studies, hospital say and rehabilitation. However, differences were found among the different groups in the cost of surgery, resulting from the type of implant used. The mean cost for SES 1 and 2 was $6475.20, for SES 3 and 4, $8057.51, and for SES 5 and 6, $16,242.5. The vulnerable population (SES 1) needs 7.34-fold its monthly income to pay for the comprehensive treatment, while the middle stratum (SES 3) needs 3.27-fold its monthly income.


CONCLUSIONS
The comprehensive cost of treatment is proportionally higher than the patients' income. It is important to point out that the systems using state-of-the-art technology, which in another setting would be inaccessible, have significant advantages when compared with the less expensive systems. Thus the economically vulnerable SES benefit from the subsidy granted by the National Institutes of Health.
Cháidez-Reyes
José Carlos
JC
Instituto Nacional de Rehabilitación. lechaide75@hotmail.com
Almazán-Díaz
Arturo
A
Espinosa-Morales
Rolando
R
Cruz-López
Francisco
F
Pérez-Jiménez
Francisco Xavier
FX
Encalada-Diaz
Iván
I
Ibarra-Ponce de León
Clemente
C
D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D050376:Bone-Patellar Tendon-Bone Grafting / Q000191:economics*; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D009984:Orthopedic Fixation Devices; D019637:Orthopedic Procedures / Q000191:economics*; D012959:Socioeconomic Factors; D013710:Tendons / Q000637:transplantation*