caa a22 4500 605458693 CHVBK 20210128100230.0 cr unu---uuuuu 210128e20150401xx s 000 0 eng 10.1007/s00167-013-2831-2 doi (NATIONALLICENCE)springer-10.1007/s00167-013-2831-2 Computer-assisted navigation in ACL reconstruction is attractive but not yet cost efficient [Elektronische Daten] [Jennifer Margier, Sandra Tchouda, Jean-Jacques Banihachemi, Jean-Luc Bosson, Stéphane Plaweski] Purpose: Conventional reconstruction of the anterior cruciate ligament (ACL) has a high success rate. Computer-assisted navigation systems (CANSs) have been developed to further improve the accuracy of tunnel positioning. What is the economic impact from the hospital perspective? Methods: Patients having a first ACL reconstruction procedure were included in a prospective multicentre open controlled study comparing two groups: CANS versus conventional surgery. The primary clinical efficacy criterion was the objective International Knee Documentation Committee score at 1-2-year follow-up. Costs were collected retrospectively nationwide. Results: No significant differences were found for the clinical effectiveness between conventional surgery (100 patients) and CANS (114 patients) at follow-up: ORadjusted 1.01 [0.36-2.84] (n.s). Junior surgeons achieved a significant mean decrease in operating time during the study period: 30% in the CANS group compared with 10% in the control group (p<0.01). The average cost of surgery was 704€ for the control group and 1,158€ for the CANS group (p<0.01). The cost of the operating room accounts for >70% of the total cost. The surgeon's status and the technical CANS learning effect influenced this cost. The cost differential between the two groups decreased with ‘CANS' expertise: 238€ and 271€ in ‘expert' centres versus 427€ to 731€ in other centres. Conclusion: While our study demonstrates the feasibility and the potential interest of CANS for training in ACL reconstruction, from a hospital perspective it is not cost efficient at present. Level of evidence: Economic and decision analysis—developing an economic or decision model, Level II. Springer-Verlag Berlin Heidelberg, 2014 Orthopaedics nationallicence Health economics nationallicence Knee joint surgery nationallicence Computer-assisted navigation nationallicence Anterior cruciate ligament reconstruction nationallicence Robotics nationallicence Margier Jennifer Cellule d'évaluation médico-économique des innovations, Pavillon Taillefer, CHU de Grenoble, 38043, Grenoble, France aut Tchouda Sandra Cellule d'évaluation médico-économique des innovations, Pavillon Taillefer, CHU de Grenoble, 38043, Grenoble, France aut Banihachemi Jean-Jacques Laboratoire TIMC-IMAG-CNRS, UMR CNRS Université Alpes-Grenoble UMR 5525, CHU Grenoble, 38043, Grenoble, France aut Bosson Jean-Luc Laboratoire TIMC-IMAG-CNRS, UMR CNRS Université Alpes-Grenoble UMR 5525, CHU Grenoble, 38043, Grenoble, France aut Plaweski Stéphane Clinique Universitaire de Chirurgie Orthopédique et de Traumatologie du Sport, Urgences Hôpital Sud, CHU de Grenoble, Grenoble, France aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/4(2015-04-01), 1026-1034 0942-2056 23:4<1026 2015 23 167 https://doi.org/10.1007/s00167-013-2831-2 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-013-2831-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Margier Jennifer Cellule d'évaluation médico-économique des innovations, Pavillon Taillefer, CHU de Grenoble, 38043, Grenoble, France aut NATIONALLICENCE 700 1- Tchouda Sandra Cellule d'évaluation médico-économique des innovations, Pavillon Taillefer, CHU de Grenoble, 38043, Grenoble, France aut NATIONALLICENCE 700 1- Banihachemi Jean-Jacques Laboratoire TIMC-IMAG-CNRS, UMR CNRS Université Alpes-Grenoble UMR 5525, CHU Grenoble, 38043, Grenoble, France aut NATIONALLICENCE 700 1- Bosson Jean-Luc Laboratoire TIMC-IMAG-CNRS, UMR CNRS Université Alpes-Grenoble UMR 5525, CHU Grenoble, 38043, Grenoble, France aut NATIONALLICENCE 700 1- Plaweski Stéphane Clinique Universitaire de Chirurgie Orthopédique et de Traumatologie du Sport, Urgences Hôpital Sud, CHU de Grenoble, Grenoble, France aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/4(2015-04-01), 1026-1034 0942-2056 23:4<1026 2015 23 167