Abstract
Background: Ankle sprains are common injuries, associated with high healthcare and societal costs. After sustaining an acute ankle sprain, ankle taping is the standard treatment in the Netherlands. Ankle braces are sometimes used as an alternative. The aim of the present study was to assess the costs-effectiveness of soft ankle bracing compared to ankle tape treatment in patients with an acute lateral ankle ligamentous sprain (ALALS). Methods: We conducted an economic evaluation from a societal perspective alongside a controlled trial. In order of presentation, patients were alternately allocated to four week treatment with a soft ankle brace or four week treatment with ankle tape. Costs and clinical outcomes with respect to re-injuries were derived from online patient questionnaires at 5, 9, 13, 26, 39, and 52 weeks after inclusion. Univariate and probabilistic sensitivity analyses were performed. Cost-effectiveness was assessed using bootstrapping with 5000 replications. Results: In total 157 patients with an ALALS were included, of which 151 (tape n=76, brace n=75) were analyzed. After one-year of follow-up, no significant clinical differences were found between both treatments groups. Mean total costs were €1,634 (SD 261) per patient in the brace group and €1,846 (SD 296) per patient in the tape group; mean difference -€212 (95%CI -854 to 436). The use of an ankle brace was less expensive in 71% of the bootstrap replications. Conclusions: In patients with ALALS, soft ankle bracing compared to ankle taping had similar clinical effect. The costs of soft bracing were lower. However, this difference was not statistically significant.
Highlights
The lateral ankle sprain is one of the most common injuries
Of the total 164 patients who were assessed for eligibility in this study, seven patients were excluded for different reasons (Figure 1)
The direct non-healthcare costs consisted of costs for complementary medicine consultation and medical devices
Summary
The lateral ankle sprain is one of the most common injuries. Incidence rates of 1.5-7 per 1000 person-years have been reported in emergency departments in the general European population [1,2,3]. The mean total costs of an ankle sprain were estimated at €360.60 [5], corresponding to a total cost of €234 million a year. These high direct healthcare costs are the result of medical consumption, (sometimes longstanding) rehabilitation [6,7], persistent residual symptoms [6,7,8] and high recurrence rates [6,9,10]. The aim of the present study was to assess the costs-effectiveness of soft ankle bracing compared to ankle tape treatment in patients with an acute lateral ankle ligamentous sprain (ALALS)
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