Microfracture Has Lowest Per-Patient Charges for Cartilage Repair Surgery

A review of per-patient average charges for cartilage repair surgery showed microfracture had the lowest charges, supporting the theory that this method of repair should be considered the gold standard of chondral defect management, according to recent study data.

“Overall, our study found that microfracture patients had the lowest PPACs [per-patient average charges] of all cartilage restoration procedures, while [autologous cartilage implantation] (ACI) had the highest,” Joanne Y. Zhang said in a presentation at the 34th International Cartilage Repair Society Annual Meeting in Los Angeles, Calif.

Using the PearlDiver database, Zhang and colleagues identified 41,191 patients who underwent a cartilage repair procedure between 2008 and 2010 and examined perioperative costs associated with the evaluation and surgical management of symptomatic focal cartilage lesions of the knee. 

According to Zhang, 93 percent of patients received microfracture and 7 percent received either osteochondral autograph transplantation surgery, osteochondral allograft or ACI. For preoperative management, results showed imaging studies had the highest cost of preoperative per-patient average charges (PPACs) and joint injection had the lowest. Additionally, rehabilitation was observed to have the highest preoperative PPACs in relation to secondary procedures for postoperative complications or patient symptoms, the study indicated.

“In terms of the surgery, the surgical procedure PPACs for microfracture was the least expensive procedure at just under $4,000, while ACI was the most expensive procedure at $10,000,” Zhang said.

Microfracture also had the lowest overall PPAC at $7,258.51 and ACI had the highest at $16,061.70 when combined for perioperative management, whereas osteochondral autograft transplantation surgery and osteochondral allograft had similar PPACs, the study data concluded.

“Finally, when we looked at the incidence and PPACs of secondary procedures after cartilage repair, we found that ACI patients were more likely to receive secondary arthroscopy with 9.3 percent of all ACI patients receiving this sort of procedure,” Zhang said. “ACI patients were also more likely to require secondary procedures addressing knee stiffness symptoms, with 4.2 percent of patients requiring this.”