Arthroscopy, sports medicine, and rehabilitation · 2026
No Significant Difference in Cost or Outcomes at 1-Year Minimum Follow-Up After Arthroscopic Partial Meniscectomy Comparing 1.9 mm Distal Chip-on-Tip Needlescope Versus 4 mm Glass Rod Lens Arthroscope: Both Treatments Are Highly Cost-Effective.
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Lubowitz James H, Lavender Chad
Аннотация
PURPOSE: To evaluate cost, outcomes, and incremental cost-effectiveness of arthroscopic partial meniscectomy comparing visualization using a 1.9 mm distal chip-on-tip needlescope versus a standard 4 mm glass rod lens arthroscope.
METHODS: We retrospectively reviewed prospectively collected data (from a larger randomized controlled trial) on patients having partial meniscectomy performed by 1 surgeon at 1 facility between February 2023 and February 2025. International Knee Documentation Committee and visual analog scale pain scores at 1-year minimum follow-up, costs, cost-effectiveness (cost/quality-adjusted life years [QALYs]), and incremental cost-effectiveness ratio (cost of 1 additional year of life in perfect health) were collected. Sensitivity analyses were assessed for potential variations in cost or effectiveness.
RESULTS: Twenty-four patients are included in each group; mean follow-up is 26 months (range 12-36). Comparing needle versus standard, mean age (years) is 50 versus 46.5 (P = .19); percent male sex is 71 versus 46 (P = .14); improvement in International Knee Documentation Committee is 58.7 versus 48.7 (P = .24); improvement in visual analog scale is 5.4 versus 4.5 (P = .55). Mean cost per case is $17,236.69 versus $16,994.00 (P = .26). Cost-effectiveness is $1177.32/QALY versus $1215.59/QALY. The incremental cost-effectiveness ratio is $367.71. Sensitivity analysis shows that if the costs of needle decreased to equal the costs of standard, needle becomes cost-neutral while providing superior outcomes (dominant), and if the effectiveness of standard arthroscopy increased to equal needle, needle becomes dominated (more expensive, effectiveness neutral).
CONCLUSIONS: Arthroscopic partial meniscectomy comparing 1.9 mm distal chip-on-tip needlescope versus 4 mm glass rod lens arthroscope results in no significant differences in cost or outcomes at 1-year minimum follow-up. Both treatments are highly cost-effective. Incremental cost-effectiveness ratio for needlescope compared with arthroscope, $367.71, is more than 2 orders of magnitude lower than the willingness-to-pay threshold of $50,000/QALY.
LEVEL OF EVIDENCE: Level IV, economic: input data from Level III study and uncertainty as examined by univariate sensitivity analysis.
METHODS: We retrospectively reviewed prospectively collected data (from a larger randomized controlled trial) on patients having partial meniscectomy performed by 1 surgeon at 1 facility between February 2023 and February 2025. International Knee Documentation Committee and visual analog scale pain scores at 1-year minimum follow-up, costs, cost-effectiveness (cost/quality-adjusted life years [QALYs]), and incremental cost-effectiveness ratio (cost of 1 additional year of life in perfect health) were collected. Sensitivity analyses were assessed for potential variations in cost or effectiveness.
RESULTS: Twenty-four patients are included in each group; mean follow-up is 26 months (range 12-36). Comparing needle versus standard, mean age (years) is 50 versus 46.5 (P = .19); percent male sex is 71 versus 46 (P = .14); improvement in International Knee Documentation Committee is 58.7 versus 48.7 (P = .24); improvement in visual analog scale is 5.4 versus 4.5 (P = .55). Mean cost per case is $17,236.69 versus $16,994.00 (P = .26). Cost-effectiveness is $1177.32/QALY versus $1215.59/QALY. The incremental cost-effectiveness ratio is $367.71. Sensitivity analysis shows that if the costs of needle decreased to equal the costs of standard, needle becomes cost-neutral while providing superior outcomes (dominant), and if the effectiveness of standard arthroscopy increased to equal needle, needle becomes dominated (more expensive, effectiveness neutral).
CONCLUSIONS: Arthroscopic partial meniscectomy comparing 1.9 mm distal chip-on-tip needlescope versus 4 mm glass rod lens arthroscope results in no significant differences in cost or outcomes at 1-year minimum follow-up. Both treatments are highly cost-effective. Incremental cost-effectiveness ratio for needlescope compared with arthroscope, $367.71, is more than 2 orders of magnitude lower than the willingness-to-pay threshold of $50,000/QALY.
LEVEL OF EVIDENCE: Level IV, economic: input data from Level III study and uncertainty as examined by univariate sensitivity analysis.