Seidl Adam J, Lombardi Nicholas J, Lazarus Mark D, Black Eric M, Maltenfort Mitchell G, Pepe Matthew D, Austin Luke S
Department of Orthopedics, Anschutz Medical Campus, University of Colorado, Aurora, CO.
Am J Orthop (Belle Mead NJ). 2016 Nov/Dec;45(7):E415-E420.
The incidence of arthroscopic rotator cuff repair (RCR) continues to rise. Given the changing healthcare climate, it is becoming increasingly important to critically evaluate current practice and attempt to make modifications that decrease costs without compromising patient outcomes. We conducted a study of the costs associated with arthroscopic anchorless (transosseous [TO]) RCR and those associated with the more commonly performed anchor-based TO-equivalent (TOE) method to determine whether there are any cost savings with the TO-RCR method. Twenty-one consecutive patients who underwent arthroscopic TO-RCR were prospectively enrolled in the study and matched on tear size and concomitant procedures with patients who underwent arthroscopic TOE-RCR. The groups' implant costs and operative times were obtained and compared. Outcome measures, including scores on the VAS (visual analog scale) for pain, the SANE (Single Assessment Numeric Evaluation), and the SST (Simple Shoulder Test), recorded at 3, 6, and >12 months after surgery, were compared between the TO and TOE groups. Mean implant cost was $946.91 less for the TO group than the TOE group-a significant difference. Mean operative time was not significantly different between the TO and TOE groups. There was significant improvement on all outcomes measures (VAS, SANE, SST) at >12 months, and this improvement was not significantly different between the groups. Arthroscopic TO-RCR provides significant cost savings over TOE-RCR with no significant difference in operative time or short-term outcomes.
关节镜下肩袖修复术（RCR）的发病率持续上升。鉴于不断变化的医疗环境，严格评估当前的治疗方法并尝试做出在不影响患者治疗效果的前提下降低成本的改进措施变得越来越重要。我们开展了一项研究，对比关节镜下无锚钉（经骨[TO]）RCR与更常用的基于锚钉的等效经骨（TOE）方法的相关成本，以确定TO-RCR方法是否能节省成本。连续21例接受关节镜下TO-RCR的患者被前瞻性纳入研究，并根据撕裂大小和同期手术与接受关节镜下TOE-RCR的患者进行匹配。获取并比较两组的植入物成本和手术时间。比较TO组和TOE组在术后3个月、6个月和超过12个月时记录的结果指标，包括疼痛视觉模拟量表（VAS）评分、单评估数字评定法（SANE）评分和简单肩部试验（SST）评分。TO组平均植入物成本比TOE组少946.91美元，差异显著。TO组和TOE组的平均手术时间无显著差异。超过12个月时，所有结果指标（VAS、SANE、SST）均有显著改善，且两组间的改善无显著差异。关节镜下TO-RCR比TOE-RCR能显著节省成本，手术时间和短期治疗效果无显著差异。
