Computer-assisted navigation in ACL reconstruction is attractive but not yet cost efficient
- Resource Type
- Authors
- Stephane Plaweski; Jennifer Margier; J.J. Banihachemi; Jean-Luc Bosson; Sandra David Tchouda
- Source
- Knee Surgery, Sports Traumatology, Arthroscopy. 23:1026-1034
- Subject
- Adult
Male
medicine.medical_specialty
Knee Joint
Anterior cruciate ligament reconstruction
Cost-Benefit Analysis
medicine.medical_treatment
Anterior cruciate ligament
Treatment outcome
medicine
Humans
Orthopedics and Sports Medicine
Prospective Studies
Anterior Cruciate Ligament
Hospitals, Teaching
Simulation
Retrospective Studies
Anterior Cruciate Ligament Reconstruction
Cost efficiency
business.industry
Robotics
Computer assisted navigation
musculoskeletal system
Surgery
Treatment Outcome
medicine.anatomical_structure
Surgery, Computer-Assisted
Multicenter study
Costs and Cost Analysis
Female
Teaching economics
France
Artificial intelligence
business
human activities
- Language
- ISSN
- 1433-7347
0942-2056
Conventional reconstruction of the anterior cruciate ligament (ACL) has a high success rate. Computer-assisted navigation systems (CANSs) have been developed to further improve the accuracy of tunnel positioning. What is the economic impact from the hospital perspective?Patients having a first ACL reconstruction procedure were included in a prospective multicentre open controlled study comparing two groups: CANS versus conventional surgery. The primary clinical efficacy criterion was the objective International Knee Documentation Committee score at 1-2-year follow-up. Costs were collected retrospectively nationwide.No significant differences were found for the clinical effectiveness between conventional surgery (100 patients) and CANS (114 patients) at follow-up: ORadjusted 1.01 [0.36-2.84] (n.s). Junior surgeons achieved a significant mean decrease in operating time during the study period: 30 % in the CANS group compared with 10 % in the control group (p 0.01). The average cost of surgery was 704eurofor the control group and 1,158eurofor the CANS group (p 0.01). The cost of the operating room accounts for70 % of the total cost. The surgeon's status and the technical CANS learning effect influenced this cost. The cost differential between the two groups decreased with 'CANS' expertise: 238euroand 271euroin 'expert' centres versus 427euroto 731euroin other centres.While our study demonstrates the feasibility and the potential interest of CANS for training in ACL reconstruction, from a hospital perspective it is not cost efficient at present.Economic and decision analysis-developing an economic or decision model, Level II.