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Study highlights cost-effectiveness of double-bundle ACL procedures
Paxton ES. Am J Sports Med. 2010. doi:10.1177/0363546510375545.
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The results of a recently published study indicate that double-bundle ACL reconstruction may be more cost-effective than single-bundle procedures when the decision-analysis model accounts for postoperative IKDC scores and revision rates.
E. Scott Paxton, MD, and colleagues used a decision analysis model with values gleaned from the literature to determine the cost-effectiveness of single- and double-bundle ACL reconstruction. They used postoperative IKDC scores and rates of revision to help determine effectiveness, according to their study abstract.
They discovered a postoperative IKDC score of an A in 64% of the double-bundle and 54% of the single-bundle cases. The cost-effective ratio per quality adjusted life-year in the baseline ratio for the single-bundle group was $6,416 and $64,371 for the double-bundle group.
The authors noted the sensitivity of the model to the proportion of IKDC A scores.
“The model is also sensitive to the utility values assigned to IKDC A and B outcomes and is less sensitive to the marginal cost of a [double-bundle] reconstruction.”
In their conclusion, the authors noted, “More research is needed to confirm whether there is any difference in the distribution of IKDC outcomes between the two techniques. Perhaps, more importantly, the lack of any other demonstrated clinical benefit from the [double-bundle] technique questions the clinical relevance of this difference in IKDC scores.”