title: Benefits of using customized instrumentation in total knee arthroplasty: results from an activity-based costing model.
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.
  
  
  METHODS
  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 <euro>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.
authors.affiliation: Sporthopaedicum Straubing, Straubing, Germany.
authors.forename: Carsten O
authors.initials: CO
authors.lastname: Tibesku
authors.forename: Pamela
authors.initials: P
authors.lastname: Hofer
authors.forename: Wesley
authors.initials: W
authors.lastname: Portegies
authors.forename: C J M
authors.initials: CJ
authors.lastname: Ruys
authors.forename: Peter
authors.initials: P
authors.lastname: Fennema
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000191:economics* / Q000295:instrumentation* / Q000379:methods; D017046:Cost Savings; D004526:Efficiency; D017721:Hospital Costs; D006801:Humans; D020370:Osteoarthritis, Knee / Q000601:surgery*; D013525:Surgical Instruments / Q000191:economics*; D013997:Time Factors