OBJECTIVES: Compare costs associated with treatment for acute or degenerative medial meniscus tears.

METHODS: Prospective, non-randomized, open-label, 24-month observational surveillance study conducted between January 2011 and December 2014 at a single institution, approved by hospital Institutional Review Board, and with patient informed consent. Patients (n=50) initiated into conservative (non-surgical) therapy or a surgical partial meniscectomy based on clinical assessment following physical examination and MRI analysis by the study investigator. Cumulative treatment costs were compared at 24 months for patients in three distinct treatment pathways during the observation time period: Group 1) conservative (non-surgical) therapy; Group 2) one or more surgical interventions without knee arthroplasty; Group 3) one or more surgical interventions with knee arthroplasty. Costs were calculated using billing record reimbursements for all services directly administered by the treating institution, and imputed for all services prescribed by investigator but provided external to the treating institution.

RESULTS: At initiation, 33 patients (67%) were prescribed conservative care, and 17 patients (33%) were prescribed a partial meniscectomy. By 24 months, 26 patients (52%) remained in Group 1, 22 patients (44%) were in Group 2, and 2 patients (4%) transitioned to Group 3. Average treatment costs were highest for Group 3 ($32,980 ± $169) compared to Group 2 ($4,931 ± $1,206), and Group 1 ($1,792 ± $1,576).

CONCLUSIONS: This study presents the first assessment of direct treatment costs associated with treating acute or degenerative meniscus deficiency in a U.S. population, during a 24-month treatment period. Findings suggest that treating acute or degenerative meniscus tears incurs substantial direct treatment costs, particularly for patients requiring knee arthroplasty or partial meniscectomy. Understanding the interplay between long-term clinical outcomes, and associated long-term treatment costs, will enable more fully-informed clinical decision-making by physicians regarding care pathways to best meet each patient’s individual clinical need for this highly-prevalent orthopaedic condition.