Shoulder Surgery: Cost Comparison Between Open and Closed Method

Everyone's under the gun to cut costs...including doctors and hospitals. In this study orthopedic surgeons compare the cost of open versus closed Bankart repair for the shoulder.

An equal number of patients were in the open and closed groups. All had repeated shoulder dislocations in the forward (anterior) direction. A Bankart repair refers to repair of a torn labrum. The labrum is a cuff of cartilage in the shoulder joint. When the shoulder pops forward out of the joint it pulls on the cartilage with enough force to tear it.

Open Bankart repairs required an overnight stay for pain control. Closed (arthroscopic) repairs were done on a same-day basis. Patients were sent home with oral pain relievers.

The authors report same-day closed surgery had lower overall costs. Arthroscopic (closed) repairs took less time. Equipment costs were higher though. The number of patients who dislocated a second time was higher in the open repair group.

Arthroscopic repair for recurring shoulder dislocation has some other advantages over open repair. The surgeon can fix anything else inside the joint that's torn during the same operation. According to these authors, younger, more active patients may do better with the open repair.