title: A cost analysis of single-row versus double-row and suture bridge rotator cuff repair methods.
abstract: OBJECTIVE
  To calculate the costs to the US healthcare system of transition from single-row (SR) to double-row (DR) rotator cuff repair (RCR) and to calculate the decrease in re-operations for re-tear that DR RCR would need to accomplish in order to render the transition cost-neutral.
  
  
  METHODS
  Standard accounting methods were used to determine the cost of a single RCR, the annual cost to the US healthcare system of rotator cuff surgery, the cost of a single-revision RCR, and the decrease in revision for re-tear rate necessary to make DR or suture bridge (SB) methods cost-neutral in comparison with SR methods. We varied tear size, operating room cost, time required for implant placement, annual tear size distribution, and repair method.
  
  
  RESULTS
  The cost of RCR ranged from $7,572 (SR, <1 cm tear) to $12,979 (DR, >5 cm tear). Complete conversion from SR RCR to a DR technique without an associated decrease in revision surgeries would increase the annual US healthcare cost between $80 million and $262 million per year. To obtain cost neutrality, use of DR or SB methods would need to result in one fewer revision in every 17 primary repairs (for tears <1 cm) to one fewer in every four primary repairs (for tears >5 cm).
  
  
  CONCLUSIONS
  Conversion from SR to DR or SB RCR techniques would result in considerable increases in healthcare expenditures. Since the large decreases in revision surgery rates necessary to justify DR or SB repairs purely on a cost basis may not be realistic or even possible, the use of these methods should be supported by evidence of improved structural healing rates and quality-adjusted life years in comparison with SR methods.
  
  
  METHODS
  IV.
authors.affiliation: Department of Orthopaedic Surgery, SUNY at Buffalo, 4949 Harlem Road, Buffalo, NY, 14226, USA, klbisson@aol.com.
authors.forename: Leslie
authors.initials: L
authors.lastname: Bisson
authors.forename: Nikola
authors.initials: N
authors.lastname: Zivaljevic
authors.forename: Samuel
authors.initials: S
authors.lastname: Sanders
authors.forename: David
authors.initials: D
authors.lastname: Pula
mesh_terms: D001182:Arthroscopy / Q000191:economics* / Q000379:methods*; D003365:Costs and Cost Analysis; D006801:Humans; D012086:Reoperation / Q000191:economics; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012421:Rupture / Q000601:surgery; D053441:Suture Anchors / Q000191:economics*; D013536:Suture Techniques / Q000191:economics*; D014481:United States