Comparison of efficiency and cost of anterior ankle arthroscopy performed with needle versus standard arthroscope.

BACKGROUND: This study uses time-driven activity-based costing (TD-ABC) to compare the cost and efficiency of a 2.0 disposable needle arthroscope to a reusable 2.7-mm arthroscope in anterior ankle arthroscopy. METHODS: This prospective, hand-timed cohort study of 60 anterior ankle arthroscopy procedures (needle=41, traditional=19) with retrospective cost review calculated procedure and OR turnover costs at a single institution from 2021 to 2023. RESULTS: Needle arthroscopy demonstrated significantly shorter OR turnover time (28.53 vs 35.65 min, p = .021), incision to joint space time (1.06 vs 2.14 min, p = .007), and total arthroscopic time (12.58 vs 16.87 min, p = .023). Total costs were not significantly different ($1891.91 vs $1957.74, p = .546). Excluding OR turnover costs, traditional arthroscopy was less costly ($669.23 vs $850.78, p < .001). CONCLUSION: Needle arthroscopy was more time efficient with no significant cost difference, offering surgeons a useful option to increase the efficiency of ankle arthroscopy and OR turnover.