title: Cost-effectiveness analysis of the most common orthopaedic surgery procedures: knee arthroscopy and knee anterior cruciate ligament reconstruction.
abstract: OBJECTIVE
  The purpose of this study was to determine the cost-effectiveness of knee arthroscopy and anterior cruciate ligament (ACL) reconstruction.
  
  
  METHODS
  Retrospective analysis of prospectively collected data from a single-surgeon, institutional review board-approved outcomes registry included 2 cohorts: surgically treated knee arthroscopy and ACL reconstruction patients. Our outcome measure is cost-effectiveness (cost of a quality-adjusted life-year [QALY]). The QALY is calculated by multiplying difference in health-related quality of life, before and after treatment, by life expectancy. Health-related quality of life is measured by use of the Quality of Well-Being scale, which has been validated for cost-effectiveness analysis. Costs are facility charges per the facility cost-to-charges ratio plus surgeon fee. Sensitivity analyses are performed to determine the effect of variations in costs or outcomes.
  
  
  RESULTS
  There were 93 knee arthroscopy and 35 ACL reconstruction patients included at a mean follow-up of 2.1 years. Cost per QALY was $5,783 for arthroscopy and $10,326 for ACL reconstruction (2009 US dollars). Sensitivity analysis shows that our results are robust (relatively insensitive) to variations in costs or outcomes.
  
  
  CONCLUSIONS
  Knee arthroscopy and knee ACL reconstruction are very cost-effective.
authors.affiliation: Taos Orthopaedic Institute Research Foundation, Taos, New Mexico 87571, USA. jlubowitz@kitcarson.net
authors.forename: James H
authors.initials: JH
authors.lastname: Lubowitz
authors.forename: David
authors.initials: D
authors.lastname: Appleby
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000191:economics / Q000706:statistics & numerical data; D059549:Anterior Cruciate Ligament Reconstruction / Q000191:economics* / Q000706:statistics & numerical data; D001182:Arthroscopy / Q000191:economics* / Q000706:statistics & numerical data; D002648:Child; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D005249:Fees and Charges / Q000706:statistics & numerical data; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D007718:Knee Injuries / Q000191:economics / Q000601:surgery*; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery; D008875:Middle Aged; D009516:New Mexico; D019057:Quality-Adjusted Life Years; D012189:Retrospective Studies; D000070600:Tibial Meniscus Injuries; D055815:Young Adult