The United Kingdom National Institute for Health and Care Excellence considers a procedure to be cost-effective if the cost per quality-adjusted life year gained falls below a threshold of £20,000-£30,000 (€22,600-33,900; US$24,600-$36,900). This study used cost per quality-adjusted life year methodology to determine the cost-utility ratio of A1 pulley release. Pre- and postoperative EuroQol 5 Dimensions 5 Likert scores were collected prospectively over 6 years from 192 patients. The median pre- and postoperative indices derived from the EuroQol 5 Dimensions 5 Likert scores were significantly different at 0.77 and 0.80. The mean life expectancy was 21 years. The mean number of quality-adjusted life years gained was 1 per patient. The mean cost-utility ratio per patient was £32,308 (€36,508; US$39,730) and £16,154 (€18,254; US$19,869) at 1 and 2 years, respectively. Provided the benefit of surgery was maintained over the remaining life expectancy, the cost-utility ratio decreased to £1537 (€1737; US$1891) per patient. A1 pulley release is cost-effective provided the benefit is maintained for 2 years. The procedure is also associated with a statistically significant improvement in quality of life. III.
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Factors affecting prognosis in open A1 pulley release surgery for trigger finger.
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Ankara Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, 06230 Altındağ, Ankara, Türkiye.
Objectives: This study aims to investigate the frequency of recurrence and prolonged postoperative symptoms in patients undergoing open A1 pulley release for trigger finger and to identify potential associated factors.
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Percutaneous ultrasound-guided A1 pulley release utilizing a modified 20-gauge spinal needle.
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Department of Sports Medicine, US Olympic & Paralympic Committee, Colorado Springs, Colorado, USA.
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Article Synopsis
- A meta-analysis was conducted to compare the effectiveness and safety of ultrasound-guided (USG) vs. blind pulley release (PR) procedures for treating Trigger Finger, using data from multiple medical databases.
- The results showed that USG-guided PR significantly reduced the occurrence of residual triggering and had a lower percentage of complications compared to blind PR, although this was not statistically significant.
- Despite a longer operation time for USG-guided PR, it resulted in lower pain scores post-surgery, making it a safer and more cost-effective option than blind PR.
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