title: Analysis of procedure-related costs and proposed benefits of using patient-specific approach in total knee arthroplasty.
abstract: Recently, patient-specific approaches to total knee arthroplasty (TKA) have been introduced that utilize preoperative magnetic resonance imaging data to manufacture custom cutting jigs specific to a patient's bony anatomy. These approaches intend to provide the benefits of accurate implant alignment while overcoming some of the proposed disadvantages of current computer navigation systems. In this study, a cost and benefit assessment of implementing the patient-specific approach compared to conventional and computer-navigated TKA was conducted at a large academic medical center. Fixed and time-dependent operating room (OR) costs were determined and compared, as well as the cost for processing operative equipment and additional procedure-related expenditures. Overall, patient-specific TKA was not cost saving in this model on a per-case basis compared to conventional methods, although it was less costly overall to the institution compared to implementing intraoperative navigation. However, the patient-specific approach provides the institution with an additional 28 minutes of available OR time per intervention based on reduction in preparation and operative times compared to conventional methods and an additional 67 minutes compared to computer navigation based on this model. This time savings is likely to provide a greater economic impact to the health care system than implant-related cost savings.
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA. tyler.watters@duke.edu
authors.forename: Tyler Steven
authors.initials: TS
authors.lastname: Watters
authors.forename: Richard C
authors.initials: RC
authors.lastname: Mather
authors.forename: James A
authors.initials: JA
authors.lastname: Browne
authors.forename: Keith R
authors.initials: KR
authors.lastname: Berend
authors.forename: Adolph V
authors.initials: AV
authors.lastname: Lombardi
authors.forename: Michael P
authors.initials: MP
authors.lastname: Bolognesi
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000191:economics* / Q000379:methods; D003362:Cost-Benefit Analysis; D006801:Humans; D008279:Magnetic Resonance Imaging; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000191:economics / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000191:economics / Q000379:methods; D014481:United States