Overview in Brazil of Anterior Cruciate Ligament (ACL) Reconstructions of the Knee from the Perspective of the Public Health System-Regional Aspects, Mortality, Costs, and Average Length of Hospital Stay (2008–2022)
DOI:
https://doi.org/10.11606/issn.2176-7262.rmrp.2025.227159Keywords:
Anterior cruciate ligament reconstruction, Hospital costs, Health regionalization, Length of hospital stayAbstract
Objective: To describe the number and regional distribution of hospitalizations, costs, average length of stay, and deaths related to Anterior Cruciate Ligament Reconstruction (ACL) funded by the Brazilian Unified Health System (SUS) from 2008 to 2022. Methods: An ecological study with a time series analysis, using data from the SUS Department of Informatics related to the procedure. Results: There were 102,624 hospitalizations during the period, with 82.5% being elective, 16.5% urgent, and 1% not identified. A decline of about 45% in the total number of surgeries was observed between 2020 and 2021 due to the COVID-19 pandemic. The regional distribution of surgeries was 47% in the Southeast; 25% in the South; 14% in the Northeast; 10% in the Central-West; and 4% in the North. The total cost was BRL 257,047,216.1, and the average cost per hospitalization was BRL 2475.63 (SD 260.7). The average length of stay was 1.9 days. The mortality rate was less than 0.01%. Total expenditures were BRL 118,817,356.7 in the Southeast, BRL 65,819,782.34 in the South, BRL 32,063,532.26 in the Northeast, BRL 30,099,482.59 in the Central-West, and BRL 10,247,062.21 in the North. The average cost per procedure was highest in the Central-West, at BRL 2795.13, while the lowest was in the North, at BRL 2297.70. Conclusion: The procedure proved to be significant in the context of Brazilian public health due to the high number of procedures and economic impact, with notable regional disparities, particularly in the Southeast. Therefore, more comprehensive studies can provide a more complete and informed view that will support health policy.
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