Understanding the costs and benefits of treatment options for ACL tears can help patients and their families choose the right course to save money, possibly return to an active lifestyle and lessen long-term repercussions.
With over 200,000 incidents per year in the United States, anterior cruciate ligament (ACL) tears is one of the most common knee injuries, particularly among active teens and young adults. Each ACL injury is different and can range from a stretched ligament to a partial tear to a complete rupture. Equally so, each type of treatment is different, from structured recovery and rehabilitation to reconstruction surgery followed by rehabilitation. Patients or their family members should have ample information about costs, potential limitations and benefits of each type of treatment before making their decision.
In situations where a patient is active, such as a high school or college athlete, and would like to return to that active lifestyle after treatment, surgery to repair a partial or complete tear is likely the best option as this surgery has a long-term success rate of 82 to 95 percent. In terms of costs, ACL reconstruction surgery is a cost-effective option for patients and society as a whole, according to a new study published in the Journal of Bone and Joint Surgery (JBJS).
While ACL reconstruction surgery has been found to be cost-effective and beneficial for patients, other treatment options exist and should not be eliminated from the decision making process. Rehabilitation can be successful for patients depending upon their activity level, age and the severity of their injury. Through this study, commissioned by the AAOS and conducted by health economists, patients now have the opportunity to compare direct and indirect costs of reconstruction surgery or rehabilitation and better understand the overall benefits of the reconstruction surgery relative to the societal and economic savings.
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Frequently Asked Questions
- What is an anterior cruciate ligament (ACL) and how is it injured?
There are four primary ligaments in your knee, the ACL being one of them. They act like strong ropes to hold the bones together and keep your knee stable. The ACL can be injured by changing direction rapidly, stopping suddenly, slowing down while running, landing from a jump incorrectly, or direct contact or collision (such as a football tackle).
- How are ACL injuries fixed?
Treatment for an ACL tear will vary depending upon the patient’s individual needs. A torn ACL will not heal without surgery. People that are physically active or involved in sports most likely require surgery. Less active, older individuals may be able to return to a quieter lifestyle without surgery.
- How was the study conducted?
Using a research tool called a Markov model, researchers estimated the value of ACL reconstruction surgery for patients by comparing direct and indirect costs between surgical and non-surgical treatments. Costs and quality of life measures were incorporated into the Markov model to estimate the impact of surgery on a patient’s lifetime costs and quality-adjusted years. Model assumptions were developed using claims and survey data as well as clinical expert opinion and peer-reviewed literature.
- What did the study conclude?
The study found ACL reconstruction is the preferred cost-effective treatment strategy for ACL tears and yields the greatest societal cost savings compared to rehabilitation. Compared with non-surgical treatment, ACL reconstruction costs $4,000 less for short-term outcomes and over $50,000 less in lifetime savings per patient.
- How will the research be used in the future and what is its impact on health care costs?
This is the first study to demonstrate the importance of a societal perspective when considering the costs and benefits of ACL repair and policies that will affect access to this procedure. It provides a foundation for assessing the value of procedures and health services. It provides a valuable perspective to patients and parents of young patients when considering the costs and benefits of ACL reconstruction surgery.