Direct treatment cost outcomes among patients with medial meniscus deficiency: results from a 24-month surveillance study

Abstract

Objective: Meniscus deficiency is highly prevalent in the United States and represents a substantial societal cost burden. The objective of this case series was to evaluate and compare direct costs associated with treatment for acute or degenerative medial meniscus deficiency.

Methods: Case series patients (n = 50) received either non-surgical therapy or an operative partial meniscectomy based on clinical assessment by the principal study investigator which included physical examination and MRI. Cumulative 24-month direct treatment costs were compared between non-surgical and operative cohorts. Direct treatment costs were calculated using billing record reimbursements for all medical services administered by the treating institution, and imputed for medical services prescribed by the treating physician but provided external to the treating institution.

Results: At study initiation, 33 patients (67%) were treated with non-surgical care, and 17 patients (33%) received a partial medial meniscectomy. By 24 months, average direct treatment costs were highest for patients who received a partial medial meniscectomy at study initiation ($4488 ± $1265) compared to patients who received non-surgical care at study initiation ($4092 ± $7466), although differences in average direct treatment costs were not statistically significant across treatment cohorts (p = .830). Average direct treatment costs were highest for the subgroup of patients who initiated non-surgical therapy but received a subsequent total knee arthroplasty during the study period (n = 2; $32,197 ± $169).

Conclusion: Findings from this case series suggests that patients with acute or degenerative meniscus deficiency incur substantial direct treatment costs related to their knee pathology, particularly for patients receiving total knee arthroplasty.

Keywords:

• Medial meniscectomy
• knee osteoarthritis
• meniscus tear

Transparency

Declaration of funding

This study was funded by Active Implants, LLC. The study sponsor was involved in all aspects of the study design and conduct.

Declaration of financial/other relationships

EBH, TM, and KD are employees of Northwell Health, which received study funding from Active Implants, LLC. EBH is a consultant for Active Implants, LLC, and receives stock options from Active Implants, LLC. JJE was an employee of Active Implants, LLC at the time the analysis was conducted. JLJ is an independent research consultant and received consulting fees from Active Implants, LLC. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

All named authors contributed to the development of this work, maintained control over the final content, and the decision to submit for publication. All named authors agree to be accountable for all aspects of the work.

Acknowledgements

We thank Erik M. Harris, MHA, an employee of Active Implants, LLC, for providing technical assistance and health economics analysis guidance for the development of this research.