Trends in decreased hospitalization for anterior cruciate ligament surgery: double-incision versus single-incision reconstruction.

Abstract

Over a 4-year period, hospital charges of 151 consecutive anterior cruciate ligament (ACL) reconstructions were retrospectively evaluated. Eighty-one patients who underwent a two-incision ACL central third autogenous patellar bone tendon bone reconstruction were compared with 72 patients who had a single-incision endoscopic reconstruction with a similar graft. Charges were adjusted for inflation. There was a statistically significant difference in hospital days (2.8 v 1.57, P = .0001), total hospital charges ($15,063 v $13,520, P = .0001), as well as operating room/hospital ward charges (P = .0001), pharmacy charges (P = .035), and physical therapy charges (P = .001). No statistical difference was observed for anesthesia or laboratory charges. A matched comparison of patients from each group who were in the hospital for 2 days showed a statistically significant reduction in operating room/hospital ward charges (P = .037), but no significant reduction in total costs. There was a trend in both groups toward shorter hospital stays in each successive year. The reduction in charges observed for the endoscopic procedure correlated with a reduction in postoperative hospital days.