No economic benefit of early knee reconstruction over optional delayed reconstruction for ACL tears

Registry enriched randomised controlled trial data

Aliasghar A Kiadaliri, Martin Englund, L. Stefan Lohmander, Katarina Steen Carlsson, Richard B Frobell

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Background To analyse 5-year cost-effectiveness of early versus optional delayed acute anterior cruciate ligament (ACL) reconstruction. Methods 121 young, active adults with acute ACL injury to a previously uninjured knee were randomised to early ACL reconstruction (n=62, within 10 weeks of injury) or optional delayed ACL reconstruction (n=59; 30 with ACL reconstruction within 6-55 months); all patients received similar structured rehabilitation. Real life data on health care utilisation and sick leave were obtained from regional and national registers. Costs and quality-adjusted life years (QALYs) were discounted at 3%. Full-analysis set (based on study randomisation) and as-treated analysis (according to actual treatment over 5 years) principles were applied. Results Mean cost of early ACL reconstruction was €4695 higher than optional delayed ACL reconstruction (p=0.19) and provided an additional 0.13 QALYs (p=0.11). Full-analysis set showed incremental net benefit of early versus optional delayed ACL reconstruction was not statistically significantly different from zero at any level. As-treated analysis showed that costs for rehabilitation alone were €13 650 less than early ACL reconstruction (p
OriginalsprogDansk
TidsskriftBritish Journal of Sports Medicine
Vol/bind50
Udgave nummer9
Sider (fra-til)558-563
Antal sider6
ISSN0306-3674
DOI
StatusUdgivet - 2016

Citer dette

Kiadaliri, Aliasghar A ; Englund, Martin ; Stefan Lohmander, L. ; Carlsson, Katarina Steen ; Frobell, Richard B. / No economic benefit of early knee reconstruction over optional delayed reconstruction for ACL tears : Registry enriched randomised controlled trial data. I: British Journal of Sports Medicine. 2016 ; Bind 50, Nr. 9. s. 558-563.
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title = "No economic benefit of early knee reconstruction over optional delayed reconstruction for ACL tears: Registry enriched randomised controlled trial data",
abstract = "Background To analyse 5-year cost-effectiveness of early versus optional delayed acute anterior cruciate ligament (ACL) reconstruction. Methods 121 young, active adults with acute ACL injury to a previously uninjured knee were randomised to early ACL reconstruction (n=62, within 10 weeks of injury) or optional delayed ACL reconstruction (n=59; 30 with ACL reconstruction within 6-55 months); all patients received similar structured rehabilitation. Real life data on health care utilisation and sick leave were obtained from regional and national registers. Costs and quality-adjusted life years (QALYs) were discounted at 3{\%}. Full-analysis set (based on study randomisation) and as-treated analysis (according to actual treatment over 5 years) principles were applied. Results Mean cost of early ACL reconstruction was €4695 higher than optional delayed ACL reconstruction (p=0.19) and provided an additional 0.13 QALYs (p=0.11). Full-analysis set showed incremental net benefit of early versus optional delayed ACL reconstruction was not statistically significantly different from zero at any level. As-treated analysis showed that costs for rehabilitation alone were €13 650 less than early ACL reconstruction (p",
author = "Kiadaliri, {Aliasghar A} and Martin Englund and {Stefan Lohmander}, L. and Carlsson, {Katarina Steen} and Frobell, {Richard B}",
year = "2016",
doi = "10.1136/bjsports-2015-095308",
language = "Dansk",
volume = "50",
pages = "558--563",
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No economic benefit of early knee reconstruction over optional delayed reconstruction for ACL tears : Registry enriched randomised controlled trial data. / Kiadaliri, Aliasghar A; Englund, Martin; Stefan Lohmander, L.; Carlsson, Katarina Steen; Frobell, Richard B.

I: British Journal of Sports Medicine, Bind 50, Nr. 9, 2016, s. 558-563.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - No economic benefit of early knee reconstruction over optional delayed reconstruction for ACL tears

T2 - Registry enriched randomised controlled trial data

AU - Kiadaliri, Aliasghar A

AU - Englund, Martin

AU - Stefan Lohmander, L.

AU - Carlsson, Katarina Steen

AU - Frobell, Richard B

PY - 2016

Y1 - 2016

N2 - Background To analyse 5-year cost-effectiveness of early versus optional delayed acute anterior cruciate ligament (ACL) reconstruction. Methods 121 young, active adults with acute ACL injury to a previously uninjured knee were randomised to early ACL reconstruction (n=62, within 10 weeks of injury) or optional delayed ACL reconstruction (n=59; 30 with ACL reconstruction within 6-55 months); all patients received similar structured rehabilitation. Real life data on health care utilisation and sick leave were obtained from regional and national registers. Costs and quality-adjusted life years (QALYs) were discounted at 3%. Full-analysis set (based on study randomisation) and as-treated analysis (according to actual treatment over 5 years) principles were applied. Results Mean cost of early ACL reconstruction was €4695 higher than optional delayed ACL reconstruction (p=0.19) and provided an additional 0.13 QALYs (p=0.11). Full-analysis set showed incremental net benefit of early versus optional delayed ACL reconstruction was not statistically significantly different from zero at any level. As-treated analysis showed that costs for rehabilitation alone were €13 650 less than early ACL reconstruction (p

AB - Background To analyse 5-year cost-effectiveness of early versus optional delayed acute anterior cruciate ligament (ACL) reconstruction. Methods 121 young, active adults with acute ACL injury to a previously uninjured knee were randomised to early ACL reconstruction (n=62, within 10 weeks of injury) or optional delayed ACL reconstruction (n=59; 30 with ACL reconstruction within 6-55 months); all patients received similar structured rehabilitation. Real life data on health care utilisation and sick leave were obtained from regional and national registers. Costs and quality-adjusted life years (QALYs) were discounted at 3%. Full-analysis set (based on study randomisation) and as-treated analysis (according to actual treatment over 5 years) principles were applied. Results Mean cost of early ACL reconstruction was €4695 higher than optional delayed ACL reconstruction (p=0.19) and provided an additional 0.13 QALYs (p=0.11). Full-analysis set showed incremental net benefit of early versus optional delayed ACL reconstruction was not statistically significantly different from zero at any level. As-treated analysis showed that costs for rehabilitation alone were €13 650 less than early ACL reconstruction (p

U2 - 10.1136/bjsports-2015-095308

DO - 10.1136/bjsports-2015-095308

M3 - Tidsskriftartikel

VL - 50

SP - 558

EP - 563

JO - British Journal of Sports Medicine

JF - British Journal of Sports Medicine

SN - 0306-3674

IS - 9

ER -