Adoption of New Medical Technologies: The Case of Customized Individually Made Knee Implants

Abstract

Objectives: To investigate the impact of insurance coverage on the adoption of customized individually made (CIM) knee implants and to compare patient outcomes and cost effectiveness of off-the-shelf and CIM implants. Methods: A system dynamics simulation model was developed to study adoption dynamics of CIM and meet the research objectives. The model reproduced the historical data on primary and revision knee replacement implants obtained from the literature and the Nationwide Inpatient Sample. Then the dynamics of adoption of CIM implants were simulated from 2018 to 2026. The rate of 90-day readmission, 3-year revision surgery, recovery period, time savings in operating rooms, and the associated cost within 3 years of primary knee replacement implants were used as performance metrics. Results: The simulation results indicate that by 2026, an adoption rate of 90% for CIM implants can reduce the number of readmissions and revision surgeries by 62% and 39%, respectively, and can save hospitals and surgeons 6% on procedure time and cut down cumulative healthcare costs by approximately $38 billion. Conclusions: CIM implants have the potential to deliver high-quality care while decreasing overall healthcare costs, but their adoption requires the expansion of current insurance coverage. This work presents the first systematic study to understand the dynamics of adoption of CIM knee implants and instrumentation. More broadly, the current modeling approach and systems thinking perspective could be used to consider the adoption of any emerging customized therapies for personalized medicine.Reports have indicated that patient satisfaction with off-the-shelf (OTS) implants can range from 75% to 92%. 12e18 Customized

Clinical and Radiological Outcomes after Knee Arthroplasty with Patient-Specific versus Off-the-Shelf Knee Implants: A Systematic Review

“…With rising healthcare costs worldwide and an increase in patients requiring TKA, there is concern that providing patients with PSI will result in higher costs compared to OTS implants. PSI indeed have higher upfront costs due to the required preoperative imaging and the customised manufacturing process [ 53 ]. However, Culler et al [ 18 ] saw no difference in overall costs, and O’Conner et al [ 21 ] even found significantly lower costs in the PSI group when looking at total postoperative costs up to one year after surgery.…”

The Use of Customized Total Knee Arthroplasty Implants to Increase Efficiency in the Operating Room and Improve Patient Outc

“…There is now over a decade of experience with customized implants, including over 100,000 implantations worldwide. Previous peer-reviewed studies confirm that patient specific TKA implants provide improved fit and alignment 9,10,11,12 , better kinematic function 13,14 , reduced short-term complication rates 15,16 , higher patient satisfaction 17,18 , and overall cost savings 15,16,19,20 when compared to standard off the shelf implants. Data from the UK National Joint Registry (UKNJR), recently released by Beyond Compliance, highlight a lower cumulative revision rate for the custom cruciate retaining implants than that of all other knee implants in the UKNJR 21 .…”

Custom Made Implant in Revision Knee Arthroplasty with AORI 3 Bone Defect: а Case Report

“…Осевая нагрузка на оперированную конечность возможна уже в раннем послеоперационном периоде [1]. Однако на сегодняшний день отсутствуют отдаленные результаты использования подобных металлоконструкций [18,28]. К недостаткам двойных конусов можно отнести малую площадь контакта с нативной костью и высокую стоимость [29].…”