The Economic Impact of Acetabular Labral Tears: A Cost-effectiveness Analysis Comparing Hip Arthroscopic Surgery and Structured Rehabilitation Alone in Patients Without Osteoarthritis

The Economic Impact of Acetabular Labral Tears: A Cost-effectiveness Analysis Comparing Hip Arthroscopic Surgery and Structured Rehabilitation Alone in Patients Without Osteoarthritis

Authors

Lodhia P, Gui C, Chandrasekaran S, Suarez-Ahedo C, Dirschl DR, Domb BG
DOI: 10.1177/0363546516645532

Purpose

To analyze the cost-effectiveness of hip arthroscopic surgery compared with structured rehabilitation for treating acetabular labral tears in patients without osteoarthritis.

Methods

A Markov decision model was used for lifetime cost-effectiveness analysis based on direct costs, quality-adjusted life years (QALYs), and probabilities derived from literature and Medicare data. Sensitivity analyses tested model robustness.

Key Findings

Hip arthroscopy was more costly (+$2653) but yielded significantly higher utility (+3.94 QALYs). The incremental cost-effectiveness ratio was $754 per QALY, indicating high cost-effectiveness. Surgery lowered the lifetime incidence of symptomatic hip osteoarthritis compared to rehabilitation.

Conclusions

Hip arthroscopic surgery is a cost-effective treatment for acetabular labral tears in patients aged 20-70 without pre-existing osteoarthritis and reduces the risk of symptomatic OA compared to rehabilitation alone.

What this means for patients

Patients with labral tears who do not have osteoarthritis may achieve better long-term hip function and lower risk of arthritis with surgery, and this treatment is cost-effective relative to rehabilitation.