Financial Analysis of Anterior Cruciate Ligament Reconstruction at Baylor University Medical Center

Abstract

Five hundred and twenty-five primary arthroscopic anterior cruciate ligament (ACL) reconstruction cases were retrospectively evaluated at our hospital with respect to operating room time, operating room cost, and hospital charges. Three main areas were financially analyzed: outpatient vs inpatient surgery, meniscus tears, and ACL grafting techniques. Patients who had their surgery done as an outpatient had, on average, a 21-minute faster operating room time, a $477 lower operating room cost, and an $840 lower hospital charge per case compared with patients who were admitted overnight (P = 0.001). Surprisingly, no statistically significant difference in operating room time or operating room cost was detected in ACL surgeries involving partial meniscectomy or meniscus repair compared with ACL surgeries without meniscus tears. When examining the 2 most popular ACL grafting techniques, 4-strand hamstring graft cases were, on average, 23 minutes faster, had $565 lower operating room costs, and had $1015 lower hospital charges compared with bone–patella tendon–bone cases (P = 0.001). Operating room time is a significant component of the overall cost of and charges for ACL surgery, and the 23-minute faster hamstring technique produced more savings than outpatient surgery.