The Journal of Arthroplasty
Volume 25, Issue 4 , Pages 558-562, June 2010

Incidence and Cost of Intraoperative Waste of Hip and Knee Arthroplasty Implants

  • Michael G. Zywiel, MD

      Affiliations

    • Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
    • ,
  • Slif D. Ulrich, MD

      Affiliations

    • Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
    • ,
  • Arnold J. Suda, MD

      Affiliations

    • Department of Orthopaedics, University of Heidelberg, Heidelberg, Germany
    • ,
  • James L. Duncan, BS

      Affiliations

    • Stryker Orthopaedics, Glen Burnie, Maryland
    • ,
  • Mike S. McGrath, MD

      Affiliations

    • Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
    • ,
  • Michael A. Mont, MD

      Affiliations

    • Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
    • Corresponding Author InformationReprint requests: Michael A. Mont, MD, Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, 2401 West Belvedere Ave, Baltimore, MD 21215.

Received 18 August 2008; accepted 16 March 2009. published online 18 May 2009.

Abstract 

Many strategies have been reported for decreasing the cost of orthopedic procedures, but prosthetic waste has not been investigated. The purpose of this study was to characterize the cost of intraoperative waste of hip and knee implants. A regional prospective assessment was performed, evaluating the reasons for component waste, the cost of the wasted implants, and where the cost was absorbed (hospital or manufacturer). Implant waste occurred in 79 (2%) of 3443 procedures, with the surgeon and operating room staff bearing primary responsibility in 73% of occurrences. The annualized cost was $109 295.35, with 67% absorbed by hospitals. When extrapolated to the whole of the United States, the annual cost to hospitals would be $36 019 000 and is estimated to rise to $112 033 000 by 2030, representing a potential target for educational programs and other cost containment measures.

Keywords: hip arthroplasty, knee arthroplasty, waste, implant cost, cost reduction

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 No benefits or funds were received in support of this study.

PII: S0883-5403(09)00087-4

doi:10.1016/j.arth.2009.03.005

The Journal of Arthroplasty
Volume 25, Issue 4 , Pages 558-562, June 2010

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