Cost-effectiveness analysis of arthroscopic surgery versus open surgery in rotator cuff repair

Objective: This study aimed to compare the open and arthroscopic rotator cuff tear treatment methods in terms of cost-effectiveness. Materials and Methods: This study includes a prospective method of a total of 104 patients, 52 with open surgery and 52 with arthroscopic surgery, in the treatment of rotator cuff tears. Cost calculations of the treatment methods were obtained from patient invoices. Oxford Shoulder Score and Short Form-36 Health Survey Questionnaire were used for effectiveness calculations. The cost-effectiveness comparison was conducted using the Incremental Cost Effectiveness Ratio (ICER) assessment. The difference between costs of open and arthroscopic surgery was analyzed using the SPSS 23.0 package program, with Mann-Whitney U test. Results: The average cost per patient was 4,838.7 Turkish Liras (TL) (866.22 USD) in open surgery and 5,770.33 TL (1,033.00 USD) according to the exchange rate at the time of writing, in arthroscopic surgery. Oxford Shoulder Score was 21.15 in open surgery and 20.83 in arthroscopic surgery. Short Form-36 Health Survey Questionnaire score was 61.92 in open surgery and 63.17 in arthroscopic surgery. The ICER calculated according to the Oxford Shoulder Score was - 2,912.37 TL (521,37 USD), while the ICER calculated according to the General Health Perception sub-scale of Short Form-36 was 745.57 TL (133,47 USD). In addition, statistical significant difference was found between the surgery, medication, medical and surgical materials, hospitalization and average cost of those treated with open surgery and those treated with arthroscopic surgery (p<0.05). Conclusion: There was no statistically significant difference between the efficacy scores of the treatment groups. However, there was statistically significant difference between costs of the treatment groups.