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Routine pathological exam offers limited cost benefit for knee arthroscopy patients
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A low prevalence of management-altering findings limited the cost-effectiveness of routine pathological examination of surgical tissue from knee arthroscopy patients, according to study results.
In a retrospective analysis of 3,797 knee arthroscopies, researchers reviewed pathology reports regarding tissue removed during partial meniscectomies and anterior cruciate ligament reconstructions to determine whether the results altered patient care. The researchers also estimated the total costs of histological exams and determined the cost per health effect by calculating the cost per discrepant and discordant diagnosis.
Study results showed a 99.3% prevalence of concordant diagnoses, a 0.7% prevalence of discrepant diagnoses and a 0.026% prevalence of discordant diagnoses. The researchers estimated the total cost of histological examinations to be $371,810; total cost of the pathology cost per discrepant diagnosis was $13,771, and the cost per discordant diagnosis was $371,810, according to the researchers.
“As a result of this study and others, we believe that hospitals and health care institutions should revise their surgical policies to exclude specimens removed during arthroscopic ACL reconstruction and partial meniscectomy from mandatory gross and/or histological examination,” the researchers wrote.
Disclosure: One or more of the authors reported a financial relationship with an entity in the biomedical arena that could be perceived to influence or have the potential to influence this work.
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