Logistical and Economic Advantages of Sterile-Packed, Single-Use Instruments for Total Knee Arthroplasty

Abstract

Keywords:total knee arthroplasty sterilization single-use instruments postdischarge complications efficiency and economic benefits a b s t r a c t Background: Total knee arthroplasty (TKA) is well established as a clinically successful and cost-effective procedure. The transition of the US healthcare system from a fee-for-service model to a value-based care model requires careful examination of patient care to ensure both quality and efficiency. Sterile-packed, single-use instruments have been introduced as a tool to help streamline the operating room (OR) logistics while reducing sterilization requirements. The aim of this study was to examine the potential logistic and economic benefits of single-use instruments compared to traditional, reusable instruments for TKA. Methods: Four variables related to TKA costs and logistics were modeled in this study: OR turnover time tray sterilization, tray management time, and 90-day infection rates. Model input data for traditional instruments and single-use instruments were based on peer-reviewed literature. A total of 200 sites and 500 cases per site were simulated using the Monte-Carlo-Technique. Results: The median total cost savings with single-use instruments was $994 per case. The largest driver for cost savings was tray sterilization. Sites with higher staff wages and sterilization costs had a larger probability of realizing greater cost savings with adoption of single-use instruments. In cases using single-use instruments, up to 51% of operating days could have accommodated an additional procedure due to the time savings in OR turnover. Conclusion: This cost modeling study observed significant potential for logistical and economic improvements in TKA with single-use vs reusable instruments. Although few studies have been conducted to measure the impact of single-use instruments in practice, the results of these simulations motivate further investigation.

Outcome of Surgical Management of Hemophilic Pseudotumor: Review of 10 Cases from Single‐Center

“…There are many measures to reduce the risk of infection, such as shortening the operation time, reasonably giving antibiotics, and so on. Single‐use instrumentation in the knee arthroplasty may also be a great choice for reducing infection rate due to enhanced maintenance of sterility and decreased risk of contamination 38 .…”

Single Use Instruments for Implanting a Contemporary Total Knee Arthroplasty System Are Accurate, Efficient, and Safe

“…Non-patient-specific single use instrumentation potentially can combine the demonstrated improvements in OR efficiency and result in economic benefit without the additional cost as seen in single use patient-specific instruments. In a recent economic modeling study using socalled Monte Carlo methods, Goldberg modeled logistical and economic advantages of sterile packed single use (non-patient specific) instrumentation for TKA [25]. They evaluated tray sterilization, tray management time, and 90-day infection rates.…”

Waste management in healthcare: during and beyond a global pandemic

“…Resterilisation requires time and can reduce efficiency, for example, in the preparation of reusable operating theatre equipment 15. Furthermore, another argument against reusing items is that the energy required for the resterilisation of reusable items can sometimes outweigh the carbon footprint of the single-use item,16 although this is less likely to be the case as the UK power sources shift over time to renewable energy.…”