Cost analysis of dermal allograft patch utilization in rotator cuff repair.

Background: To perform an analysis of intraoperative costs associated with arthroscopic rotator cuff repair (RCR) acellular dermal allograft patch augmentation and interposition. Methods: This was a matched cohort retrospective cost identification analysis. We identified patients who underwent arthroscopic RCR with acellular dermal allograft patch augmentation or interposition between 2014 and 2023 at a single academic center. These were matched based on age and tear size to a cohort of patients who underwent arthroscopic RCR without a patch. Patients without preoperative MRI data were excluded. Via chart review, we collected demographics, medical comorbidities, tear characteristics, and intraoperative repair characteristics. Patch and control patients were compared with paired t tests. Differences in costs between patch and control patients were assessed using multivariable regression controlling for observable covariates. Results: One hundred and thirty-two (132) total patients were included: 66 patch patients and 66 control patients. The patch group demonstrated more tear retraction and utilized single row medial repair more frequently. Multivariable analysis revealed that there was a $4930 total direct cost increase with the utilization of a patch ( Conclusion: The addition of a patch increases the total direct cost by $4930 when compared to arthroscopic RCR without a patch. Increased ASA, biceps tenodesis, and use of a double row repair construct were also associated with increased cost.