What is the average cost of acl surgery

In knee arthroscopy surgery procedure , a small incision is made on your knee; through which a camera is inserted. This camera is connected to a monitor that displays the affected ligament along with other neighboring tissues. A shaver like instrument is used to remove the torn ligament.

When an autograft is being used, a cut is made large enough to pass it through channels made in your bones so that it reaches desired location. Finally you have a new ACL at the center of your knee. To hold this new ligament, surgeons connect it to nearby bones, by means of screws. The channels that were made in bones will gradually fill with time. This will further tighten the new ligament in its position. The ACL surgery is concluded with stitches wherever necessary.

Knee braces and crutches are required for 1 to 4 weeks post surgery. South Korea. United Arab Emirates. United Kingdom. Dialysis treatment Elective surgery Eye surgery Gender reassignment Gynaecology Hair loss treatment Infertility treatment. Medical spa and wellness Neurosurgery Obesity surgery Organ transplantation surgery Orthopaedic surgery Rehabilitation Scans and investigations.

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Patients who underwent concomitant collateral ligament MCL, LCL repair or reconstruction had the highest total cost as well as the greatest difference in median costs between the immediate procedure and total health care utilization. Patients who underwent isolated ACL repair or reconstruction had the lowest total cost; however, patients who underwent ACL repair or reconstruction with concomitant microfracture had the smallest difference in median costs between the immediate procedure and total health care utilization.

An analysis of patients who underwent 1 ACL reconstruction observed in the database compared with patients who underwent 2 or more ACL reconstructions observed in the database showed that total immediate procedure cost for the subsequent reconstruction was slightly lower than the total immediate procedure cost for the index reconstruction Table 4. However, the total cost for health care utilization during the 9-month period of care surrounding the reconstruction was greater for the subsequent reconstruction than for the index reconstruction.

On average, there were 0. Excludes ACL reconstructions prior to period of coverage. This study provides a descriptive analysis of the cost of ACL reconstruction among commercially insured patients in the United States that can be used to better understand the effect of these injuries on the health care system.

These results provide a glimpse into the injuries that lead to the burden of musculoskeletal problems in the United States. The incidence of ACL injuries 14 , 15 and the high costs identified for the health care system provide additional support for implementation of injury prevention initiatives and other cost-saving programs.

The documentation of cost of surgical intervention can be used to refine cost-benefit analyses of injury prevention programs. Additionally, the increased cost of health care utilization associated with subsequent reconstructions, in addition to the evidence that patients who sustain 1 ACL injury are at risk for a second injury, 16 , 18 , 19 suggests that injury prevention programs should be developed and validated in order to incorporate them into the rehabilitation protocol for patients recovering from ACL reconstruction.

An analysis comparing cost of an isolated ACL reconstruction to cost of ACL reconstruction with various concomitant procedures suggested that both immediate procedure and total health care costs were greatest among patients who underwent concomitant collateral ligament MCL, LCL repair or reconstruction, followed by concomitant PCL reconstruction and concomitant meniscal repair.

These procedures also had the highest difference in median costs between the immediate procedure and total health care utilization, which suggests higher health care costs during the perioperative period.

These additional procedures likely reflect more severe injuries that require additional surgical supplies, increased surgical time, and additional physical therapy and other rehabilitation costs. It is important to note that the categories of concomitant procedures are not mutually exclusive.

Therefore, a patient who had multiple concomitant procedures eg, ACL reconstruction, collateral ligament repair, and meniscal repair would have his or her costs included in each procedure calculation eg, collateral ligament and meniscal repair. Our expectation was that subsequent reconstructions would be more costly than initial reconstructions due to the potential for increased intra-articular damage at the time of the second reconstruction. Contrary to our expectations, patients who had a subsequent ACL reconstruction had fewer concomitant procedures performed at the subsequent procedure compared with the initial procedure 0.

These results may be due to the inability to distinguish between revision and contralateral reconstructions in the second reconstruction category. This suggests that patients may require more health care utilization, such as physical therapy or imaging, after a second reconstruction.

Consequently, patients who undergo more than 1 ACL reconstruction should be a priority when identifying strategies to reduce the burden of health care costs in orthopaedics. There are limitations to this descriptive analysis of cost of ACL reconstruction.

First, this study only includes ACL reconstructions that were performed arthroscopically in the outpatient setting. While outpatient arthroscopic reconstruction currently represents the majority of ACL reconstructions performed in the United States, 2 , 14 the results are not generalizable to open or inpatient ACL reconstructions.

Similarly, our methodology specifically utilized a database created out of records for patients who have commercial insurance, and thus, the results are only generalizable to that population. This database also does not contain individuals who are insured by Medicaid, which insures low-income patients, or uninsured patients, and costs associated with ACL reconstruction may also be quite different among those subsets of the population.

Also, the immediate procedure cost was determined by summing payments for a 3-day window surrounding the procedure. This decision was made in order to account for aggregate costs of the procedure, including associated costs for the facility, physician, anesthesia, and other care.

Although this choice may result in small misclassification of other claims into the immediate procedure costs, the nature of this type of procedure, including the typical acute presentation, mean that this window is appropriate for calculating the immediate procedure costs. Unfortunately, we were not able to assess procedure costs more granularly, such as specific equipment or facility expenses. Therefore, we cannot comment on whether a specific area contributed most to rising procedure costs.

In the analysis of subsequent injuries, we were unable to distinguish between revision ACL reconstruction and contralateral ACL reconstruction due to lack of laterality information in this database. The ability to identify true revision ACL reconstruction would be potentially valuable in understanding health care system costs, particularly health care utilization surrounding the procedure. However, we believe the information is still valuable for understanding the health care costs associated with multiple reconstructions versus a single reconstruction.

In addition, it is possible that some patients had a prior ACL reconstruction that was not captured in the database or in the study. We required that patients have only 3 months of continuous enrollment in the database prior to the reconstruction.

This likely results in some misclassification of prior injuries as first injuries and may have attenuated the difference in cost between first and subsequent injuries.

For the purposes of this study, we used a 9-month period for determining health care utilization, based on previous literature about the typical period of care 7 , 12 ; however, costs of complex injuries or those who sustain complications related to the procedure may not be adequately represented in this analysis due to the cutoff at 6 months postoperative for reporting cost. The method used any knee-related diagnosis code could include charges from a knee injury that were unrelated to the ACL surgery, but could also potentially miss charges that were related to the ACL surgery but were not knee related, such as postoperative infection or complications from anesthesia.

This approach has to be weighed against the limitations of the 2 other methods. Using a 9-month period of care and considering all charges to be related to the ACL surgery likely overestimates the cost of the procedure by including incurred charges that were unrelated. On the other hand, the method using a diagnosis code match of the procedure to other charges billed likely underestimates the cost of the procedure by excluding incurred charges that were related, since some episodes of care may not be linked by diagnosis code due to nuances of billing methods.

Finally, this study did not compare the costs of the procedure to other ACL treatment options, as this was a descriptive analysis using an insurance claims database. We also did not perform statistical analyses to assess the significance of the trend over time; however, the results were adjusted to values to account for inflation, allowing for visual comparison over time.

Finally, we were not able to include other measures of economic burden, including lost wages or disability-adjusted life years DALYs. One or more of the authors has declared the following potential conflict of interest or source of funding: Major funding for this research came from a grant provided by the University of North Carolina Junior Development Award.

National Center for Biotechnology Information , U. Orthop J Sports Med. Published online Jan Mackenzie M.

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