2025 ISAKOS Biennial Congress Paper
Osteochondroplasty With or Without Labral Repair is More Cost-Effective Compared to Arthroscopic Lavage With or Without Labral Repair for Treatment of Young Adults With Femoroacetabular Impingement: A Cost-Utility Analysis Based on Data From an RCT
Jiajun Yan, MSc, Hamilton, ON CANADA
Olufemi R. Ayeni, MD, PhD, MSc, FRCSC, Hamilton, ON CANADA
Yoan Bourgeault-Gagnon, MD, FRCSC, Sherbrooke, Quebec CANADA
McMaster University, Hamilton, Ontario, CANADA
FDA Status Not Applicable
Summary
The findings of this cost-utility analysis based on data from the Femoroacetabular Impingement Randomised Controlled Trial (FIRST) trial indicate that over a lifetime time horizon, osteochondroplasty, with or without labral repair, is a cost-effective treatment strategy for young adults with FAI. Future research involving real-word data is needed to further validate these findings.
Abstract
Objectives:
To conduct a cost-utility analysis of osteochondroplasty with or without labral repair compared to arthroscopic lavage with or without labral repair for femoroacetabular impingement (FAI).
Methods
A Markov model was constructed to compare the lifetime quality-adjusted life years (QALYs) and costs of the two treatment strategies. The target population was surgical FAI patients aged 36 years. The primary data source was patient-level data from the Femoroacetabular Impingement Randomised Controlled Trial (FIRST), which evaluated the efficacy of the surgical correction of FAI via arthroscopic osteochondroplasty with or without labral repair compared to arthroscopic lavage with or without labral repair in Canada. Long-term data were extrapolated using a generalized gamma model. The primary outcome was the incremental cost-effectiveness ratio (ICER), calculated by dividing the difference in costs by the difference in quality-adjusted life years (QALYs) between osteochondroplasty and lavage, with or without labral repair. Probabilistic sensitivity analyses and one-way sensitivity analyses were used to characterize uncertainty of model parameters and assumptions.
Results
Over a lifetime horizon, osteochondroplasty, with or without labral repair, had a greater expected benefit (0.63 QALYs gained per patient) and lower costs ($955.89 saved per patient), as compared with lavage with or without labral repair. Probabilistic sensitivity analyses demonstrated that the probability of osteochondroplasty, with or without labral repair, being cost-effective was 90.5% at a commonly used willingness-to-pay threshold of $50,000/QALY. Across all one-way sensitivity analyses, osteochondroplasty with or without labral repair remained a cost-effective option.
Conclusion
Over a lifetime time horizon, osteochondroplasty, with or without labral repair, is a cost-effective treatment strategy for young adults with FAI. Future research involving real-word data is needed to further validate these findings.