Aurora Advanced Healthcare, Milwaukee, WI 53209, USA.
J Shoulder Elbow Surg. 2010 Jul;19(5):716-21. doi: 10.1016/j.jse.2009.10.011. Epub 2010 Feb 4.
The objective of this study was to determine mean cost and operative time differences between mini-open and all-arthroscopic rotator cuff repair techniques at surgical centers of low, intermediate, and high annual rotator cuff repair volume.
The 2006 New York State Ambulatory Surgery Database (NY-SASD) was utilized. It represents 100% of all outpatient procedures performed in hospital-affiliated and freestanding surgical centers, containing 10,658,923 patients for 2006 alone. Only patients who had an arthroscopic acromioplasty and either open or arthroscopic rotator cuff repair were included, leaving 5,224 patients for the study. These were divided into 2 groups: the mini-open group (1,334) and the all-arthroscopic group (3,890). Surgical center volume data were divided into 3 groups: low volume (<75 rotator cuff repairs per year), intermediate volume (75-199 rotator cuff repairs per year), and high volume (200+ rotator cuff repairs per year).
Patient age and gender were normally distributed within the 2 groups with no significant differences between them (P = .82 and P = .31, respectively). Operative time was significantly shorter in the mini-open group (103 minutes) compared to the all-arthroscopic group (113 minutes), P < .00001. Surgical charges were also significantly less in the mini-open group ($7,841) compared to the all-arthroscopic group ($8,985), P < .00001. Regardless of the repair method, high volume surgical centers were significantly more expensive when compared to low and intermediate volume centers, P < .00001.
The mini-open rotator cuff repair technique requires significantly less operative time and is significantly less expensive than the all-arthroscopic repair. Regardless of the repair technique, high volume surgical centers cost significantly more than low and intermediate volume surgical centers.
本研究旨在确定在肩部修复手术量低、中、高的外科中心，微创开放式与全关节镜下肩袖修复技术之间的平均成本和手术时间差异。
本研究使用了 2006 年纽约州门诊手术数据库（NY-SASD）。该数据库代表了所有在医院附属和独立外科中心进行的门诊手术的 100%，仅 2006 年就包含了 10658923 例患者。仅纳入接受关节镜下肩峰成形术和开放式或关节镜下肩袖修复术的患者，研究共纳入 5224 例患者。这些患者被分为两组：微创开放式组（1334 例）和全关节镜组（3890 例）。外科中心的手术量数据分为三组：低量（每年<75 例肩袖修复）、中量（每年 75-199 例肩袖修复）和高量（每年>200 例肩袖修复）。
两组患者的年龄和性别呈正态分布，两组间无显著差异（P=0.82 和 P=0.31）。微创开放式组的手术时间（103 分钟）明显短于全关节镜组（113 分钟），P<0.00001。微创开放式组的手术费用（7841 美元）也明显低于全关节镜组（8985 美元），P<0.00001。无论修复方法如何，与低量和中量外科中心相比，高量外科中心的费用明显更高，P<0.00001。
微创开放式肩袖修复技术所需的手术时间明显更短，费用也明显低于全关节镜修复。无论修复技术如何，高量外科中心的费用明显高于低量和中量外科中心。
