title: Arthroscopic Transosseous and Transosseous-Equivalent Rotator Cuff Repair: An Analysis of Cost, Operative Time, and Clinical Outcomes.
abstract: The incidence of arthroscopic rotator cuff repair (RCR) continues to rise. Given the changing healthcare climate, it is becoming increasingly important to critically evaluate current practice and attempt to make modifications that decrease costs without compromising patient outcomes. We conducted a study of the costs associated with arthroscopic anchorless (transosseous [TO]) RCR and those associated with the more commonly performed anchor-based TO-equivalent (TOE) method to determine whether there are any cost savings with the TO-RCR method. Twenty-one consecutive patients who underwent arthroscopic TO-RCR were prospectively enrolled in the study and matched on tear size and concomitant procedures with patients who underwent arthroscopic TOE-RCR. The groups' implant costs and operative times were obtained and compared. Outcome measures, including scores on the VAS (visual analog scale) for pain, the SANE (Single Assessment Numeric Evaluation), and the SST (Simple Shoulder Test), recorded at 3, 6, and >12 months after surgery, were compared between the TO and TOE groups. Mean implant cost was $946.91 less for the TO group than the TOE group-a significant difference. Mean operative time was not significantly different between the TO and TOE groups. There was significant improvement on all outcomes measures (VAS, SANE, SST) at >12 months, and this improvement was not significantly different between the groups. Arthroscopic TO-RCR provides significant cost savings over TOE-RCR with no significant difference in operative time or short-term outcomes.
authors.affiliation: Department of Orthopedics, Anschutz Medical Campus, University of Colorado, Aurora, CO. adam.seidl@ucdenver.edu.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Seidl
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Lombardi
authors.forename: Mark D
authors.initials: MD
authors.lastname: Lazarus
authors.forename: Eric M
authors.initials: EM
authors.lastname: Black
authors.forename: Mitchell G
authors.initials: MG
authors.lastname: Maltenfort
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Pepe
authors.forename: Luke S
authors.initials: LS
authors.lastname: Austin
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000191:economics* / Q000379:methods; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D017006:Rotator Cuff / Q000601:surgery*; D012782:Shoulder / Q000601:surgery; D016896:Treatment Outcome