{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:35:26Z","timestamp":1791596126094,"version":"4.3.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Treatment strategies for meniscal tears range from nonoperative management to surgical intervention. However, national trends in cost-related outcomes and patient factors related to the failure of nonoperative management remain poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To describe the costs associated with nonoperative versus operative management of meniscal tears in the 2 years after diagnosis and examine the relationship between patient characteristics and timing of surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cross-sectional study; Level of evidence, 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This study was conducted using the MarketScan databases. Patients diagnosed with a meniscal tear without concomitant knee osteoarthritis between January 1 and December 31, 2017, were included. The primary outcome was the total cost of meniscal tear-related procedures\u2014including insurance deductibles, coinsurance, and net insurance payments\u2014in the 2 years after diagnosis. Procedures included were as follows: (1) surgery\u2014including meniscectomy or meniscal repair; (2) physical therapy; (3) medication\u2014including nonsteroidal anti-inflammatories, opioids, and acetaminophen; (4) intra-articular injections\u2014including professional fee, hyaluronic acid, and corticosteroids; (5) imaging; and (6) clinic visits to orthopaedic specialists. Patients were grouped as having undergone early surgery (ES) (\u22643 months of diagnosis), late surgery (LS) (&gt;3 months after diagnosis), or no surgery (NS). Multivariate logistic regression was performed to determine the likelihood of undergoing surgery early and failing nonoperative treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The study population included 29,924 patients with a mean age of 43.9 \u00b1 12.9 years (ES: n = 9507 (31.8%); LS: n = 2021 (6.8%); NS: n = 18,396 (61.5%)). Complex (36.6%) and medial (58.8%) meniscal tears were the most common type and location of injuries, respectively. The mean cost of management per patient was $3835 \u00b1 $4795. Costs were lower in the NS group ($1905 \u00b1 $3175) compared with the ES group ($6759 \u00b1 $5155), while the highest costs were observed in the LS group ($7649 \u00b1 $5913) ( P &lt; .001). Patients who were men, &gt;40 years, and with a bucket-handle or lateral meniscal tear were more likely to undergo surgery early. Patients who were men, &lt;30 years, and with a complex tear or tear to the lateral meniscus were more likely to fail nonoperative management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Nonoperative management had the lowest cost burden and should be recommended for patients with appropriate indications. However, if surgery is necessary, it should be performed earlier.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259671241257881","type":"journal-article","created":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T11:16:18Z","timestamp":1722251778000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Costs and Timing of Surgery in the Management of Meniscal Tears"],"prefix":"10.1177","volume":"12","author":[{"given":"Darren Z.","family":"Nin","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, New England Baptist Hospital, Boston, Massachusetts, USA"},{"name":"Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya-Wen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishna","family":"Mandalia","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, New England Baptist Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Parman","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, New England Baptist Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7656-8482","authenticated-orcid":false,"given":"Sarav S.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, New England Baptist Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun J.","family":"Ramappa","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C.","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, New England Baptist Hospital, Boston, Massachusetts, USA"},{"name":"Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth G.","family":"Matzkin","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,7,29]]},"reference":[{"issue":"3","key":"bibr1-23259671241257881","first-page":"557","volume":"29","author":"Baker P","year":"2002","journal-title":"J Rheumatol"},{"key":"bibr2-23259671241257881","doi-asserted-by":"publisher","DOI":"10.1136\/oem.60.10.794"},{"key":"bibr3-23259671241257881","doi-asserted-by":"publisher","DOI":"10.1302\/2058-5241.2.160056"},{"key":"bibr4-23259671241257881","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000001386"},{"key":"bibr5-23259671241257881","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2021.36.e292"},{"key":"bibr6-23259671241257881","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0800777"},{"key":"bibr7-23259671241257881","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctim.2017.05.007"},{"key":"bibr8-23259671241257881","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2016.03.006"},{"key":"bibr9-23259671241257881","unstructured":"IBM. MarketScan Research Databases\u2014Databases. Published September 27, 2021. 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Consumer price index for all urban consumers: all items in U.S. city average. FRED, Federal Reserve Bank of St. Louis. Published January 1, 1947. 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