title: Costs, quality of life and cost-effectiveness of arthroscopic and open repair for rotator cuff tears: an economic evaluation alongside the UKUFF trial.
abstract: OBJECTIVE
  A trial-based comparison of the use of resources, costs and quality of life outcomes of arthroscopic and open surgical management for rotator cuff tears in the United Kingdom NHS was performed using data from the United Kingdom Rotator Cuff Study (UKUFF) randomised controlled trial.
  
  
  METHODS
  Using data from 273 patients, healthcare-related use of resources, costs and quality-adjusted life years (QALYs) were estimated at 12 months and 24 months after surgery on an intention-to-treat basis with adjustment for covariates. Uncertainty about the incremental cost-effectiveness ratio for arthroscopic versus open management at 24 months of follow-up was incorporated using bootstrapping. Multiple imputation methods were used to deal with missing data.
  
  
  RESULTS
  There were no significant differences between the arthroscopic and open groups in terms of total mean use and cost of resources or QALYs at any time post-operatively. Open management dominated arthroscopic management in 59.8% of bootstrapped cost and effect differences. The probability that arthroscopic management was cost-effective compared with open management at a willingness-to-pay threshold of £20 000 per QALY gained was 20.9%.
  
  
  CONCLUSIONS
  There was no significant overall difference in the use or cost of resources or quality of life between arthroscopic and open management in the trial. There was uncertainty about which strategy was most cost-effective. Cite this article: Bone Joint J 2016;98-B:1648-55.
authors.affiliation: University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK.
authors.forename: J
authors.initials: J
authors.lastname: Murphy
authors.affiliation: University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK.
authors.forename: A
authors.initials: A
authors.lastname: Gray
authors.affiliation: University of Oxford, Windmill Road, Headington, Oxford OX3 7LD, UK.
authors.forename: C
authors.initials: C
authors.lastname: Cooper
authors.affiliation: University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK.
authors.forename: D
authors.initials: D
authors.lastname: Cooper
authors.affiliation: University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK.
authors.forename: C
authors.initials: C
authors.lastname: Ramsay
authors.affiliation: University of Oxford, Windmill Road, Headington, Oxford OX3 7LD, UK.
authors.forename: A
authors.initials: A
authors.lastname: Carr
mesh_terms: D000368:Aged; D001182:Arthroscopy / Q000191:economics* / Q000379:methods / Q000534:rehabilitation; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data; D006302:Health Services Research / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000191:economics / Q000379:methods; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D000070636:Rotator Cuff Injuries / Q000191:economics* / Q000534:rehabilitation / Q000601:surgery*; D013222:State Medicine / Q000191:economics; D016896:Treatment Outcome; D006113:United Kingdom
keywords: Cost-effectiveness analysis; Cost-utility analysis; Economic evaluation; Rotator cuff tear