Anderson Orthopaedic Clinic, 2445 Army Navy Drive, Arlington, VA 22206, USA.
Clin Orthop Relat Res. 2010 May;468(5):1418-22. doi: 10.1007/s11999-009-1178-y. Epub 2009 Dec 18.
Prior studies suggest the cost of allograft anterior cruciate ligament (ACL) reconstruction is less than that for autograft reconstruction. Charges in these studies were influenced by patients requiring inpatient hospitalization. QUESTION/PURPOSE: We therefore determined if allograft ACL reconstruction would still be less costly if all procedures were performed in a completely outpatient setting.
We retrospectively reviewed 155 patients who underwent ACL reconstruction in an ambulatory surgery center between 2001 and 2004; 105 had an autograft and 50 had an allograft. Charges were extracted from itemized billing records, standardized to eliminate cost increases, and categorized for comparison. Surgeon and anesthesiologist fees were not included in the analysis. Groups were compared for age, gender, mean total cost, mean cost of implants, and several other cost categories.
The mean total cost was $5465 for allograft ACL reconstruction and $4872 for autograft ACL reconstruction. There were no differences in complications between the two groups.
Allograft ACL reconstruction was more costly than autograft ACL reconstruction in the outpatient setting. The cost of the allograft outweighs the increased surgical time needed for harvesting an autograft.
Level II, economic and decision analyses. See Guidelines for Authors for a complete description of levels of evidence.
先前的研究表明同种异体移植物前交叉韧带（ACL）重建的成本低于自体移植物重建。这些研究中的费用受到需要住院治疗的患者的影响。问题/目的：因此，我们确定如果所有程序都在完全门诊环境下进行，同种异体 ACL 重建是否仍然具有成本效益。
我们回顾性分析了 2001 年至 2004 年间在门诊手术中心接受 ACL 重建的 155 名患者；105 例采用自体移植物，50 例采用同种异体移植物。从逐项计费记录中提取费用，进行标准化以消除成本增加，并进行分类比较。外科医生和麻醉师的费用未包含在分析中。比较两组的年龄、性别、平均总费用、植入物的平均费用和其他几个费用类别。
同种异体 ACL 重建的平均总费用为 5465 美元，自体移植物 ACL 重建的平均总费用为 4872 美元。两组之间的并发症无差异。
在门诊环境下，同种异体 ACL 重建比自体移植物 ACL 重建成本更高。同种异体移植物的成本超过了采集自体移植物所需的额外手术时间。
二级，经济和决策分析。有关证据水平的完整描述，请参见作者指南。
