Cost-effectiveness analysis of the most common orthopaedic surgery procedures: knee arthroscopy and knee anterior cruciate ligament reconstruction

Arthroscopy. 2011 Oct;27(10):1317-22. doi: 10.1016/j.arthro.2011.06.001. Epub 2011 Aug 19.


Purpose: The purpose of this study was to determine the cost-effectiveness of knee arthroscopy and anterior cruciate ligament (ACL) reconstruction.

Methods: Retrospective analysis of prospectively collected data from a single-surgeon, institutional review board-approved outcomes registry included 2 cohorts: surgically treated knee arthroscopy and ACL reconstruction patients. Our outcome measure is cost-effectiveness (cost of a quality-adjusted life-year [QALY]). The QALY is calculated by multiplying difference in health-related quality of life, before and after treatment, by life expectancy. Health-related quality of life is measured by use of the Quality of Well-Being scale, which has been validated for cost-effectiveness analysis. Costs are facility charges per the facility cost-to-charges ratio plus surgeon fee. Sensitivity analyses are performed to determine the effect of variations in costs or outcomes.

Results: There were 93 knee arthroscopy and 35 ACL reconstruction patients included at a mean follow-up of 2.1 years. Cost per QALY was $5,783 for arthroscopy and $10,326 for ACL reconstruction (2009 US dollars). Sensitivity analysis shows that our results are robust (relatively insensitive) to variations in costs or outcomes.

Conclusions: Knee arthroscopy and knee ACL reconstruction are very cost-effective.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Ambulatory Surgical Procedures / economics
  • Ambulatory Surgical Procedures / statistics & numerical data
  • Anterior Cruciate Ligament Reconstruction / economics*
  • Anterior Cruciate Ligament Reconstruction / statistics & numerical data
  • Arthroscopy / economics*
  • Arthroscopy / statistics & numerical data
  • Child
  • Cohort Studies
  • Cost-Benefit Analysis
  • Fees and Charges / statistics & numerical data
  • Female
  • Hospital Costs / statistics & numerical data
  • Humans
  • Knee Injuries / economics
  • Knee Injuries / surgery*
  • Male
  • Menisci, Tibial / surgery
  • Middle Aged
  • New Mexico
  • Quality-Adjusted Life Years
  • Retrospective Studies
  • Tibial Meniscus Injuries
  • Young Adult