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Abstract
PurposeHealthcare costs are increasingly garnering more media attention and there is increasing focus on improving efficiencies in daily practice. Orthopedic surgery is also subject to these fiscal pressures, particularly in arthroplasty surgeries, secondary to high volumes with costly equipment. Total knee arthroplasties (TKA) are one of the most common surgical procedures, with over 64,000 annual cases in Canada. Even marginal cost reductions per procedure can be compounded over the large volume to result in considerable savings. This study’s purpose is to investigate and quantify the cost of wasted intraoperative cement used in primary TKA.MethodsResidual amounts of wasted bone cement were collected and measured following uncomplicated primary TKAs performed by the senior authors in a high-volume arthroplasty centre between January and June 2017. Stryker Simplex® with Tobramycin Bone Cement was the specific institutional cement used.ResultsOne hundred and two primary total knee arthroplasties were investigated. The results revealed that an average 91.2 g of surgical cement was wasted per case, with less than 30 g retained in the bone-implant interface (26.8 g). Institutional costs per package of cement is $120.62, amounting to $2.04 per gram of cement. This represents a value of $186.25 CAD per case.ConclusionOn average, each primary TKA procedure wastes 91.2 g of bone cement per case. The value of this wasted cement is $186.25 CAD per TKA. When extrapolated to the most recent recorded numbers of TKAs done in Canada, that figure nears $12 million. The results of this study are important, as they reveal a potential source to target for both waste reduction and cost control.
Highlights
How to cite this article Yan J R, Oreskovich S, Oduwole K, et al (November 26, 2018) Cement Waste During Primary Total Knee Arthroplasty and its Effect on Cost Savings: An Institutional Analysis
The results revealed that an average 91.2 g of surgical cement was wasted per case, with less than 30 g retained in the bone-implant interface (26.8 g)
Oftentimes excess cement remains after a completed total knee arthroplasty (TKA), and not much is wasted in terms of volume of product, a considerable amount is wasted in terms of cost of product
Summary
How to cite this article Yan J R, Oreskovich S, Oduwole K, et al (November 26, 2018) Cement Waste During Primary Total Knee Arthroplasty and its Effect on Cost Savings: An Institutional Analysis. The rising prevalence and cost of joint replacement surgery is becoming increasingly burdensome on healthcare institutions throughout Canada. A recent report from the Canadian Joint Replacement Registry estimated 53,207 hip arthroplasties and 64,204 knee arthroplasties in 2016, an 18.1% and 15.7% increase respectively, since 2011 [1]. Total knee arthroplasty (TKA), comprise over half of all total joint arthroplasty procedures, which, according to North American projections, is a trend with discernible momentum [1, 2]. There is palpable pressure on hospitals and orthopaedic surgeons to integrate cost control into modern practice
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