Consumer Prices for Surgical Management of End-Stage Hallux Rigidus. Issue 4 (16th October 2019) - Smyth, Niall A.
Category: Midfoot/Forefoot, Healthcare economics Introduction/Purpose: Hallux rigidus is the most prevalent arthritic condition of the foot. Treatment of end-stage disease traditionally consists of a first metatarsophalangeal joint (MTPJ) arthrodesis, however the use of a synthetic cartilage implant is becoming more common. With the high prevalence of disease and implementation of new treatment modalities, healthcare consumers should be aware of the costs associated with management. The purpose of this study was to determine access to the cost and variability in price of first MTPJ arthrodesis and synthetic cartilage implantation. Methods: Forty academic centers were contacted using a standardized patient script. The patient was a 59-year-old female who had failed conservative treatment of hallux rigidus. Each institution was contacted up to three times in an attempt to obtain a full bundled operative quote for a first MTPJ arthrodesis and synthetic cartilage implantation. Results: Twenty centers (50%) provided a quote for first MTPJ arthrodesis and 15 centers (38%) provided a quote for synthetic cartilage implantation. Only 14 centers (35%) were able to provide a quote for both procedures. The mean bundled price for MTPJ arthrodesis was $21, 767 (range, $8, 417 – $39, 265). The mean bundled price for synthetic cartilage implantation was $21, 546 (range, $4, 903 – $74, 145). There was no statistically significant difference between the bundled price for first MTPJ arthrodesis and synthetic cartilage implantation. Conclusion: There was limited availability of consumer prices for first MTPJ arthrodesis and synthetic implantation, therefore impeding healthcare consumers' decision making. There was a wide range of quotes for both procedures, indicating potential cost savings.