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Clin Orthop Relat Res. 2009 May;467(5):1171-9. doi: 10.1007/s11999-008-0674-9. Epub 2009 Jan 27.

Resource utilization in clubfoot management.

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Helen DeVos Children's Hospital, 1425 Michigan Street NE, Suite D, Grand Rapids, MI 49503, USA.

Erratum in

  • Clin Orthop Relat Res. 2010 Apr;468(4):1186.


Both private and socialized healthcare systems require treatments to be not only effective, but also cost-efficient. Although the Ponseti method of clubfoot treatment is effective, its cost-effectiveness has not been demonstrated. We compared the difference in resource use between two prospective cohorts treated for clubfoot by either the Ponseti method or below-knee casting followed by primary surgical release in the socialized healthcare system of New Zealand. Using these cohorts and US billing data, costs of treating these cohorts in the US healthcare system were also calculated. Treatment of initial deformity, recurrences, and complications in both cohorts were included in the final assessment. Twenty-six patients (40 feet) were enrolled in the Ponseti cohort and 29 (46 feet) in the primary surgical cohort. For most patients, the Ponseti method was more cost-effective than the primary surgical treatment in both healthcare systems. The cost of treating both cohorts was lower in the socialized system than in the US healthcare system.


Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.

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