The ACL (anterior cruciate ligament) connects the femur to the tibia in each knee. The injury results in either a partial or complete tear of the ligament, and is common among athletes. Women seem to have a higher incidence of this injury. Surgery is usually the best option to repair the injury, but there are cost considerations before embarking on the surgery.
The average cost of ACL surgery depends on whether or not you have insurance. If you have insurance, the average cost is about $1,850 (ranging from $800 to $3,000). Some of the out-of-pocket expenses include hospital admission fees and co-pays. Naturally, the insurance company must cover the procedure. If you don’t have insurance, the average cost is $35,000 (ranging from $20,000 to $50,000).
If you suffer an ACL tear in your knee, the process to prepare for surgery actually begins with physical therapy to prepare the knee for surgery (physical therapy is part of the post-operative care as well, but is considered an additional cost). During the surgery, the surgeon should remove the bad tendon and replace it, either with a tendon graft of a tendon from a cadaver. The surgeon should also examine the joint and check the new tendon for flexibility and stability.
Some of the accessories needed to recover from the injury will cost extra. Braces and crutches are usually covered by insurance, but can run as high as $500 if you’re not covered. During recovery, post-operative rehabilitation fees can run as high as $75 per hour. There’s also the potential for extra costs in terms of prescription drugs to manage pain and, in a worst case scenario, a second reconstruction surgery, if the first one is rejected or is damaged.
In some cases, patients can get a discount on the surgery if they’re able to pay cash or with a credit card. But patients should look at the fine print, as some hospitals apply the discount only if you don’t use insurance.
If you need ACL surgery, you should see several doctors before settling on a surgeon. In some cases, surgery isn’t the best option. Rehabilitation can help if the ligament is only partially torn. Blood clots, knee pain and loss of motion in the knee can be some of the side effects of surgery. And, there’s some risk in operating on a younger person with an ACL injury, if he has not stopped growing.