Cost-Effectiveness Analysis of Hip Arthroscopic Surgery and Structured Rehabilitation Alone in Individuals With Hip Labral Tears: Response
Authors
Lodhia P, Gui C, Chandrasekaran S, Suarez-Ahedo C, Dirschl DR, Domb BG.
Am J Sports Med. 2017 Mar;45(3):NP2-NP4. doi: 10.1177/0363546517691279.
Purpose
To clarify and respond to comments on the cost-effectiveness analysis comparing hip arthroscopic surgery versus structured rehabilitation alone for patients with labral tears without osteoarthritis.
Methods
Used Markov decision model and literature review to evaluate cost-effectiveness, age effects, and rates of symptomatic osteoarthritis (OA) and total hip arthroplasty (THA) in surgical candidates.
Key Findings
Hip arthroscopy shown to be more cost-effective with lower symptomatic OA incidence than rehabilitation alone in patients aged 20–70 without preexisting OA. Rehabilitation remains important preoperatively; surgery considered after rehab failure. Sensitivity analyses support robustness of findings despite modeling assumptions.
Conclusions
Hip arthroscopy is a cost-effective treatment for labral tears in appropriate surgical candidates, though further research on rehabilitation's role and long-term OA progression is needed.
What Does This Mean For Patients
Patients with hip labral tears may benefit more from arthroscopic surgery after trying rehabilitation, as surgery can reduce OA risk and is cost-effective, but rehab remains a key first step.