Cost-Effectiveness of Operative Versus Nonoperative Management of Acute Achilles Tendon Ruptures:

摘要

Category:Ankle, SportsIntroduction/Purpose:The management of acute Achilles tendon ruptures remains controversial. Proponents of operative treatment cite lower rates of re-rupture, the potential for better functional outcomes and earlier return to activity. However, operative management incurs the added risks of surgical complications and the considerable cost of the surgical procedure. The goal of this study was to evaluate the cost-effectiveness of operative versus nonoperative management of acute Achilles tendon ruptures using the best available evidence regarding the costs and benefits of these two strategies.Methods:A Markov cost-utility analysis was conducted from the societal perspective to evaluate the cost-effectiveness of operative versus nonoperative management of acute Achilles tendon ruptures over a two-year time-period. Hospital costs were derived from New York SPARCS data, physician and rehabilitation costs were derived from Medicare physician fee schedules, and indirect costs of missed wor...