Top

Archives of Orthopaedic and Trauma Surgery

Published in:

01-03-2013 | Knee Arthroplasty

Benefits of using customized instrumentation in total knee arthroplasty: results from an activity-based costing model

Authors: Carsten O. Tibesku, Pamela Hofer, Wesley Portegies, C. J. M. Ruys, Peter Fennema

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 3/2013

Abstract

Objective

The growing demand for total knee arthroplasty (TKA) associated with the efforts to contain healthcare expenditure by advanced economies necessitates the use of economically effective technologies in TKA. The present analysis based on activity-based costing (ABC) model was carried out to estimate the economic value of patient-matched instrumentation (PMI) compared to standard surgical instrumentation in TKA.

Methodology

The costs of the two approaches, PMI and standard instrumentation in TKA, were determined by the use of ABC which measures the cost of a particular procedure by determining the activities involved and adding the cost of each activity. Improvement in productivity due to increased operating room (OR) turn-around times was determined and potential additional revenue to the hospital by the efficient utilization of gained OR time was estimated.

Results

Increased efficiency in the usage of OR and utilization of surgical trays were noted with patient-specific approach. Potential revenues to the hospital were estimated with the use of PMI by efficient utilization of time saved in OR. Additional revenues of €78,240 per year were estimated considering utilization of gained OR time to perform surgeries other than TKA.

Conclusions

The analysis suggests that use of PMI in TKA is economically effective when compared to standard instrumentation.

Theofilou P, Panagiotaki H (2012) The association between musculoskeletal disorders and quality of life. J Trauma Treatment 1:e101CrossRef

Brooks PM (2006) The burden of musculoskeletal disease—a global perspective. Clin Rheumatol 25(6):778–781PubMedCrossRef

Oliveria SA, Felson DT, Reed JI, Cirillo PA, Walker AM (1995) Incidence of symptomatic hand, hip, and knee osteoarthritis among patients in a health maintenance organization. Arthritis Rheum 38:1134–1141PubMedCrossRef

Andrianakos AA, Kontelis LK, Karamitsos DG, Aslanidis SI, Georgountzos AI, Kaziolas GO, Pantelidou KV, Vafiadou EV, Dantis PC, ESORDIG Study Group (2006) Prevalence of symptomatic knee, hand, and hip osteoarthritis in Greece.The ESORDIG study. J Rheumatol 33:2507–2513PubMed

Martin J, Meltzer H, Elliot D (1988) OPCS surveys of disability in Great Britain. Report 1. The prevalence of disability among adults. Wiley, Office of Population Censuses and Surveys, Social Survey Division, London

Dillon CF, Rasch EK, Gu Q, Hirsch R (2006) Prevalence of knee osteoarthritis in the United States: arthritis data from the Third National Health and Nutrition Examination Survey 1991–94. J Rheumatol 33(11):2271–2279PubMed

Woolf AD, Pfleger B (2003) Burden of major musculoskeletal conditions. Bull World Health Organ 81(9):646–656PubMed

Goyen M, Debatin JF (2009) Healthcare costs for new technologies. Eur J Nucl Med Mol Imaging 36(Suppl 1):S139–S143PubMedCrossRef

Drummond M (2006) Pharmacoeconomics: friend or Foe? Ann Rheum Dis 65(Suppl 3):iii44–iii47PubMedCrossRef

10.

Kurtz SM, Ong KL, Lau E, Widmer M, Maravic M, Gómez-Barrena E, de Pina Mde F, Manno V, Torre M, Walter WL, de Steiger R, Geesink RG, Peltola M, Röder C (2011) International survey of primary and revision total knee replacement. Int Orthop 35(12):1783–1789PubMedCrossRef

11.

Otten R, van Roermund PM, Picavet HS (2010) Trends in the number of knee and hip arthroplasties: considerably more knee and hip prostheses due to osteoarthritis in 2030. Ned Tijdschr Geneeskd 154:A1534PubMed

12.

Kurtz SM, Lau E, Ong K, Zhao K, Kelly M, Bozic KJ (2009) Future young patient demand for primary and revision joint replacement: national projections from 2010 to 2030. Clin Orthop Relat Res 467(10):2606–2612PubMedCrossRef

13.

Kurtz S, Ong K, Lau E, Mowat F, Halpern M (2007) Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 89(4):780–785PubMedCrossRef

14.

King JC, Manner PA, Stamper DL, Schaad DC, Leopold SS (2011) Is minimally invasive total knee arthroplasty associated with lower costs than traditional TKA? Clin Orthop Relat Res 469(6):1716–1720PubMedCrossRef

15.

Noble JW Jr, Moore CA, Liu N (2012) The value of patient-matched instrumentation in total knee arthroplasty. J Arthroplasty 27(1):153–155PubMedCrossRef

16.

Watters TS, Mather RC 3rd, Browne JA, Berend KR, Lombardi AV Jr, Bolognesi MP (2011) Analysis of procedure-related costs and proposed benefits of using patient-specific approach in total knee arthroplasty. J Surg Orthop Adv 20(2):112–116PubMed

17.

Lewis S (1984) Prospective pricing and DRGs. West J Med 140:123–128PubMed

18.

Ben-Arieh D, Qian L (2003) Activity-based cost management for design and development stage. Int. J. Prod Econ 83:169–183CrossRef

19.

Healy WL, Rana AJ, Iorio R (2011) Hospital economics of primary total knee arthroplasty at a teaching hospital. Clin Orthop Relat Res 469(1):87–94PubMedCrossRef

20.

Goodacre S, McCabe C (2002) An introduction to economic evaluation. Emerg Med J 19:198–201PubMedCrossRef

21.

Lombardi AV, Berend KR, Adams JB (2008) Patient-specific approach in total knee arthroplasty. Orthopedics 31:927–930PubMedCrossRef

Title: Benefits of using customized instrumentation in total knee arthroplasty: results from an activity-based costing model
Authors: Carsten O. Tibesku
Pamela Hofer
Wesley Portegies
C. J. M. Ruys
Peter Fennema
Publication date: 01-03-2013
Publisher: Springer-Verlag
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 3/2013
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-012-1667-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Benefits of using customized instrumentation in total knee arthroplasty: results from an activity-based costing model

Abstract

Objective

Methodology

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methodology

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 3/2013

Minimally invasive distal linear metatarsal osteotomy for correction of hallux valgus: a preliminary study of clinical outcome and analytical radiographic results via a mapping system

The effect of additional video documentation to photo documentation in wrist arthroscopies on intra- and interobserver reliability

Relationship between distal screws and femoral arteries in closed hip nailing on computed tomography angiography

X-treme CT analysis of cancellous bone at the rotator cuff insertion in human individuals with osteoporosis: superficial versus deep quality

One-stage posterior debridement, transforaminal lumbar interbody fusion and instrumentation in treatment of lumbar spinal tuberculosis: a retrospective case series

Medial placement of the acetabular component in an alumina-on-alumina total hip arthroplasty: a comparative study with propensity score matching