Despite substantially higher initial failure rates, meniscus repair is associated with improved long-term outcomes and overall cost savings compared with meniscectomy, according to recent research.
Using a decision-analytic Markov disease progression model, researchers with the University of California-San Francisco and the University of Washington in Seattle assessed the cost-effectiveness of meniscus repair compared with meniscectomy by computing the 30-year incremental cost-effectiveness ratio and relative event risks. The researchers derived costs from 2014 United States national average reimbursement amounts and the published literature.
Results showed a gradual increase in discounted quality-adjusted life years from 16.37 to 16.53 and an overall discounted savings of $2,384 associated with meniscus repair vs. meniscectomy. The researchers found substantial reductions in osteoarthritis and total knee reconstruction with meniscus repair. However, meniscus repair was also associated with an increase in failure rate.
With longer follow-up, clinical benefit and cost-effectiveness improved with meniscal repair, according to the researchers. Sensitivity analysis showed meniscus repair was the dominant treatment strategy for patients up to age 55 and was cost-effective up to age 70.