Generic Volar Locking Plate Use in Distal Radius Fractures: A Prospective Randomized Study to Evaluate Clinical Outcomes and Cost Reduction.

Autor:	Doxey SA; TRIA Orthopaedic Institute, Bloomington, MN, USA.; Park Nicollet Methodist Hospital, St. Louis Park, MN, USA., Kleinsmith RM; TRIA Orthopaedic Institute, Bloomington, MN, USA.; Park Nicollet Methodist Hospital, St. Louis Park, MN, USA., Qian LJ; University of Minnesota, Minneapolis, USA., Husband JB; TRIA Orthopaedic Institute, Bloomington, MN, USA.; University of Minnesota, Minneapolis, USA., Bohn DC; TRIA Orthopaedic Institute, Bloomington, MN, USA.; University of Minnesota, Minneapolis, USA., Cunningham BP; TRIA Orthopaedic Institute, Bloomington, MN, USA.; Park Nicollet Methodist Hospital, St. Louis Park, MN, USA.; University of Minnesota, Minneapolis, USA.
Jazyk:	angličtina
Zdroj:	Hand (New York, N.Y.) [Hand (N Y)] 2024 Nov 06, pp. 15589447241293168. Date of Electronic Publication: 2024 Nov 06.
DOI:	10.1177/15589447241293168
Abstrakt:	Background: The purpose of this study was to evaluate differences in 90-day clinical outcomes between patients treated with generic volar locking plates (VLPs) and conventional VLPs in distal radius fractures. Secondary aims included assessing for differences in surgical characteristics and cost between the groups. Methods: From November 2022 to April 2023, a prospective block-randomized study was undertaken in which surgeons alternated between using a generic VLP and a conventional VLP each month. The institution's chargemaster database was cross-referenced for implant cost. Primary outcomes were 90-day readmission, reoperation, and mortality rates. Secondary outcomes included estimated blood loss, tourniquet time, and implant cost. Results: A total of 66 patients were included. Most were women (n = 61, 92.4%), with an average age of 61.0 ± 11.5 years. There were no significant differences in age, sex, smoking status, AO Foundation/Orthopaedic Trauma Association classification, or tourniquet time between patients who received generic and conventional implants. The average total cost was higher with conventional implants than generic implants($1348.61 ± 100.77 and $702.38 ± 47.83, respectively; P < .001). The largest difference in cost came from pegs and screws that were used ($640.77 ± 90.93 vs $268.47 ± 45.93, P < .001). No patients experienced complications such as readmission, reoperation, or death within 90 days. Conclusions: Total implant cost was lower for procedures where generic VLPs were used. Cost differences between generic and conventional implants are driven by the variable selection of pegs and screws. With no differences in 90-day outcomes, surgeons may consider using generic implants as a way of increasing the value of care delivery. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: B.P.C’s spouse is the CEO and founder of CODE Technology. B.P.C. is a member of the AAOS Health Care Systems and Patient-reported Outcome Measures Committees as well as the chair of the OTA Practice Management Committee. He is also a member of the editorial board for the Journal of Orthopaedic Business. D.C.B. has stock in Bristol Myers Squibb, Eli Lilly, and Pfizer. The remaining authors have no conflicts of interest to disclose.
Databáze:	MEDLINE
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