title: Immediate costs of mini-open versus arthroscopic rotator cuff repair in an Asian population.
abstract: While there has been increasing interest in minimally invasive surgery, the expenses incurred by patients undergoing this form of surgery have not been comprehensively studied. The authors compared the costs borne by patients undergoing arthroscopic rotator cuff repair with the standard mini-open repair at a tertiary hospital in an Asian population.
  
  
  
  This was a retrospective cohort study. The authors studied the inpatient hospital bills of patients following rotator cuff tear repair between January 2010 and October 2014 via the hospital electronic medical records system. 148 patients had arthroscopic repair and 78 had mini-open repair. The cost of implants, consumables, and the total cost of hospitalization were analyzed. Operative times and length of stay for both procedures were also studied. Constant scores and American Shoulder Elbow Scores (ASES) were recorded preoperatively and at 1 year postoperatively.
  
  
  
  Three fellowship-trained surgeons performed arthroscopic repairs and one performed the mini-open repair. The cost of implants and consumables was significantly higher with arthroscopic repair. The duration of surgery was also significantly longer with that technique. There was no difference in length of stay between the two techniques. There was also no difference in Constant scores or ASES scores, both preoperatively and at 1 year postoperatively.
  
  
  
  The immediate costs of mini-open repair of rotator cuff tears are significantly less than that of arthroscopic repair. Most of the difference arises from the cost of implants and consumables. Equivalent functional outcomes from both techniques suggest that mini-open repair may be more cost-effective.
authors.affiliation: 1 University Orthopaedics, Hand & Reconstructive Microsurgery Cluster, National University Hospital, Singapore.
authors.forename: Yik Jing
authors.initials: YJ
authors.lastname: Hui
authors.affiliation: 1 University Orthopaedics, Hand & Reconstructive Microsurgery Cluster, National University Hospital, Singapore.
authors.forename: Alex Quok An
authors.initials: AQ
authors.lastname: Teo
authors.affiliation: 1 University Orthopaedics, Hand & Reconstructive Microsurgery Cluster, National University Hospital, Singapore.
authors.forename: Siddharth
authors.initials: S
authors.lastname: Sharma
authors.affiliation: 1 University Orthopaedics, Hand & Reconstructive Microsurgery Cluster, National University Hospital, Singapore.
authors.forename: Bryan Hsi Ming
authors.initials: BH
authors.lastname: Tan
authors.affiliation: 2 Yong Loo Lin School of Medicine, National University of Singapore.
authors.forename: V Prem
authors.initials: VP
authors.lastname: Kumar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy / Q000191:economics*; D044466:Asian People; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000070636:Rotator Cuff Injuries / Q000191:economics / Q000601:surgery*; D012846:Singapore; D016896:Treatment Outcome; D055815:Young Adult
keywords: arthroscopic surgery; cost and cost analysis; rotator cuff