DOI: 10.1177/23259671261490733 ISSN: 2325-9671

Short-Term Value of Arthroscopic Rotator Cuff Repair: A Value-Based Health Care Approach From the LaTour Group

Anthony Pernoud, Hugo Bothorel, Yonas Abraham, Alexandre Lädermann
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Background:

Arthroscopic rotator cuff repair (ARCR) is the standard surgical treatment for rotator cuff disease. As health care systems transition toward value-based health care (VBHC), assessing the value of ARCR, defined as outcomes achieved relative to costs, is essential.

Purpose:

To evaluate the value delivered by ARCR using a VBHC framework and to identify factors associated with this value.

Study Design:

Economic and decision analysis; Level of evidence, 4.

Methods:

The primary outcome of this retrospective study was value at 12 months, defined as the ratio of quality to cost. Quality was assessed using improvements in validated patient-reported outcome measures (PROMs) and tendon healing at 12 months. Cost included direct surgical expenses expressed relative to diagnosis-related group (DRG)–based reimbursement. Multivariable linear regression analyses identified factors independently associated with value , quality , and cost .

Results:

A total of 506 patients (mean age, 55 ± 10 years, 71% male) were included. PROMs significantly improved postoperatively. The mean quality score was 1.7 ± 0.9, with 80% of patients achieving a substantial quality score. The mean cost ratio was 0.9 ± 0.3. The mean value was 2.0 ± 1.3 (95% CI, 1.9-2.1), with 87% of patients achieving a value ≥1 (minimal clinically important difference-based) and 77% achieving a value ≥1 (substantial clinical benefit-based). Higher value was associated with lower preoperative PROMs, lower tendon retraction, type D lesion, absence of workers’ compensation, and shorter hospital stay, whereas long head of biceps (LHB) tenodesis or preexisting LHB rupture were associated with reduced value .

Conclusion:

ARCR delivers high value , achieving clinically meaningful outcomes at controlled costs. The delivered value was influenced by both baseline patient characteristics and surgical factors.

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