The Economic Impact of Acetabular Labral Tears: A Cost-effectiveness Analysis Comparing Hip Arthroscopic Surgery and Structured Rehabilitation Alone in Patients Without Osteoarthritis
Authors: Lodhia P, Gui C, Chandrasekaran S, Suarez-Ahedo C, Dirschl DR, Domb BG
Purpose
To compare the cost-effectiveness of arthroscopic surgery versus structured rehabilitation for labral tears in patients without OA.
Methods
Lifetime Markov model using clinical data and Medicare costs. Outcome measures included quality-adjusted life years (QALYs), cost, and long-term OA incidence.
Key Findings
- Surgery yielded +3.94 more QALYs than rehab alone.
- Incremental cost-effectiveness ratio: $754 per QALY (well below typical willingness-to-pay thresholds).
- Surgery reduced lifetime risk of symptomatic OA.
Conclusions
In appropriate patients (age 20–70, no OA), hip arthroscopy is highly cost-effective and may delay or prevent OA progression.
What This Means for Providers:
- Hip arthroscopy offers economic and clinical benefits for non-OA patients with labral pathology.
- Structured rehab remains essential preoperatively, but surgery should be offered if conservative measures fail.
- Health systems and payers may favor surgical treatment given its long-term cost-efficiency and QALY gains.