Peter N Chalmers1, Erin Granger2, Richard Nelson3, Minkyoung Yoo4, Robert Z Tashjian2. 1. Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah, U.S.A.. Electronic address: p.n.chalmers@gmail.com. 2. Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah, U.S.A. 3. Department of Epidemiology, University of Utah, Salt Lake City, Utah, U.S.A. 4. Economics Department, University of Utah, Salt Lake City, Utah, U.S.A.
Abstract
BACKGROUND: The purpose of this study was to simultaneously examine costs, functional outcomes, and tendon healing after arthroscopic rotator cuff repair. METHODS: This was a retrospective, single-surgeon, single-hospital study. Pre- and postoperative Simple Shoulder Test (SST), visual analog scale (VAS) pain, and American Shoulder and Elbow Surgeons (ASES) scores, and postoperative magnetic resonance images (MRIs) were obtained. Direct costs were derived using a unique, validated tool. Costs included overall total direct cost, which included facility use costs, medication costs, supply costs, and other ancillary costs. RESULTS: 85 patients had a minimum 1-year follow-up of functional outcomes (mean of 1.24 years, range 1-3.2 years) and 56 of 85 (66%) had postoperative MRI healing data at an average follow-up of 1.3 years (range 1-3.2 years). Increased direct cost was associated with ASA class III (P < .001) compared with ASA class I, procedures performed at the main operative room (P = .017) compared with those at the surgical center, single-row repair (P < .001) compared with double-row repair, medium and large tear sizes (P < .001 and P = .001) compared with small tear, and increased number of anchors (P ≤ .001 or P < .039 for each additional). Arthroscopic biceps tenodesis was associated with decreased improvement in SST, VAS-pain, and ASES scores (P < .001, .012, and .024), whereas infraspinatus atrophy and large/massive tear size was associated with decreased improvement in ASES scores (P = .03). Obesity (P = .004) and smoking (P = .034) were associated with greater improvement in VAS-pain scores as these were associated with decreased preoperative scores. Seventy percent of tears healed. CONCLUSIONS: Within our study, factors that increased direct costs were outcome neutral, and factors that improved outcome were cost neutral. LEVEL OF EVIDENCE: Level IV, retrospective.
BACKGROUND: The purpose of this study was to simultaneously examine costs, functional outcomes, and tendon healing after arthroscopic rotator cuff repair. METHODS: This was a retrospective, single-surgeon, single-hospital study. Pre- and postoperative Simple Shoulder Test (SST), visual analog scale (VAS) pain, and American Shoulder and Elbow Surgeons (ASES) scores, and postoperative magnetic resonance images (MRIs) were obtained. Direct costs were derived using a unique, validated tool. Costs included overall total direct cost, which included facility use costs, medication costs, supply costs, and other ancillary costs. RESULTS: 85 patients had a minimum 1-year follow-up of functional outcomes (mean of 1.24 years, range 1-3.2 years) and 56 of 85 (66%) had postoperative MRI healing data at an average follow-up of 1.3 years (range 1-3.2 years). Increased direct cost was associated with ASA class III (P < .001) compared with ASA class I, procedures performed at the main operative room (P = .017) compared with those at the surgical center, single-row repair (P < .001) compared with double-row repair, medium and large tear sizes (P < .001 and P = .001) compared with small tear, and increased number of anchors (P ≤ .001 or P < .039 for each additional). Arthroscopic biceps tenodesis was associated with decreased improvement in SST, VAS-pain, and ASES scores (P < .001, .012, and .024), whereas infraspinatus atrophy and large/massive tear size was associated with decreased improvement in ASES scores (P = .03). Obesity (P = .004) and smoking (P = .034) were associated with greater improvement in VAS-pain scores as these were associated with decreased preoperative scores. Seventy percent of tears healed. CONCLUSIONS: Within our study, factors that increased direct costs were outcome neutral, and factors that improved outcome were cost neutral. LEVEL OF EVIDENCE: Level IV, retrospective.
Authors: A A Narvani; M A Imam; A Godenèche; E Calvo; S Corbett; A L Wallace; E Itoi Journal: Ann R Coll Surg Engl Date: 2020-01-03 Impact factor: 1.891
Authors: Jesse N Steadman; Andrew R Stephens; Guo Wei; Angela P Presson; Nikolas H Kazmers Journal: Plast Reconstr Surg Date: 2022-02-01 Impact factor: 4.730
Authors: Nikolas H Kazmers; Evangelia L Lazaris; Chelsea M Allen; Angela P Presson; Andrew R Tyser Journal: Plast Reconstr Surg Date: 2019-02 Impact factor: 4.730