Chicago Bulls star guard Derrick Rose has begun to play basketball for the first time since undergoing surgery to repair a torn anterior cruciate ligament (ACL) in his left knee 1 ½ years ago. For Rose, the cost of not having surgery was clear — he is among the highest paid athletes in the world — but what does the average person have to lose?
For the first time, researchers have determined the economic benefit of having reconstructive ACL surgery, offering helpful information for the more than 200,000 people — often amateur athletes but including people of any age — who suffer ACL tears in the U.S. every year. The average lifetime benefit of having surgery is $50,000 per patient and there is an estimated lifetime savings in the U.S. of $10.1 billion annually, according to a study published Oct. 2in the Journal of Bone and Joint Surgery.
The figures include direct costs, such as the price of surgery and rehabilitation, and indirect factors, including the ability to work, earnings and disability payments.
“ACL reconstruction is the preferred cost-effective treatment strategy for ACL tears and yields reduced costs compared to rehabilitation alone once indirect cost factors are considered,” said Dr. Bernard Bach, one of the study’s authors and head of the division of sports medicine at Rush University Medical Center.
An ACL injury can severely limit a person's level of activity and result in long-term repercussions such as an increased risk of knee osteoarthritis, which can lead to debilitating pain and make walking and standing difficult.
"We know ACL patients who need surgery benefit from it, but until now the true value of ACL reconstruction surgery has been hard to quantify," said study author Dr. John R. Tongue, a past president of the American Academy of Orthopaedic Surgeons. "Considering many ACL patients are young and eager to get back to their active lives, this study provides a key perspective they can look to when evaluating surgery versus rehabilitation."
Each ACL injury is different and can range from a stretched ligament to a partial tear to a complete rupture, so each type of treatment is different, from structured rehabilitation to surgical reconstruction followed by rehabilitation. Patients and their family members should be given ample information about costs, potential limitations and benefits of each type of treatment before making their decision.
In situations where a patient is active, such as a high school or college athlete, and would like to return to that active lifestyle after treatment, surgery to repair a tear is often the best option, offering a long-term success rate of 82 to 95 percent.
Rehabilitation can also be successful for patients depending upon their activity level, age and the severity of their injury. This study gives patients the opportunity to compare direct and indirect costs of surgical reconstruction or rehabilitation, and better understand the overall benefits of each treatment relative to the societal and economic savings.
The full study is available at www.ANationInMotion.org/value/ACL.