title: Material costs of anterior cruciate ligament reconstruction with hamstring tendons by two different techniques.
abstract: BACKGROUND
  In France, approximately 36,000 anterior cruciate ligament (ACL) reconstruction surgical procedures are performed every year. Technical progress, in particular arthroscopy, has made surgery more precise, but more expensive. In a context of healthcare cost containment, the increase in the cost of technology must be compared to the improved outcome for the patients. The main aim of this study was to determine all material costs related to ACL reconstruction using hamstring tendons. This study also compared the material costs between the two arthroscopic techniques: standard or "all-inside".
  
  
  METHODS
  A retrospective study of material costs was performed in 2011. With the standard technique, the tibial tunnel was drilled from outside to inside, while with the all-inside technique two tunnels were drilled from inside to outside. All of the material used from the first swab to the final bandage was reported. It was classified into three categories: reusable arthroscopy material, disposable arthroscopic material, and disposable surgical supplies. The costs were those of our supplier in 2011 (Arthrex™) and based on Public Hospitals of Paris (AP-HP) public contract tariffs.
  
  
  RESULTS
  Standard ligament reconstruction was less expensive than the all-inside technique: 791.59€ versus 931.06€ excluding taxes (hors taxes [HT]), respectively. The largest percentage of expenses was allocated to disposable material use (81 and 84%).
  
  
  CONCLUSIONS
  Possible avenues of savings are limited: all the material used was necessary. To control costs, correct use and good maintenance of instruments are the most important elements.
  
  
  METHODS
  Level IV. Economic and decision analyses, retrospective study.
authors: Hôpitaux Universitaires Paris Ile-de-France Ouest, AP-HP, 92100 Boulogne-Billancourt, France. cournapeau.jerome@gmail.com
authors: J
authors: J
authors: Cournapeau
authors: S
authors: S
authors: Klouche
authors: P
authors: P
authors: Hardy
mesh_terms: D059549:Anterior Cruciate Ligament Reconstruction / Q000191:economics* / Q000379:methods*; D001182:Arthroscopy / Q000191:economics* / Q000379:methods*; D003365:Costs and Cost Analysis; D004209:Disposable Equipment; D017743:Equipment Reuse; D006801:Humans; D007902:Length of Stay; D012189:Retrospective Studies