Reduction in rate of implant waste associated with robotic-assisted total hip arthroplasty
| Autor: | Tony S. Shen, Ryan Cheng, Yu-Fen Chiu, Alexander S. McLawhorn, Mark P. Figgie, Geoffrey H. Westrich |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2024 |
| Předmět: |
hip arthroplasty
implant waste cost savings robotics robotic-assisted total hip arthroplasties total hip arthroplasty (tha) acetabular shells polyethylene primary total hip arthroplasty femoral components femoral heads anesthesiologists acetabular component orthopaedic implant Orthopedic surgery RD701-811 |
| Zdroj: | Bone & Joint Open, Vol 5, Iss 8, Pp 715-720 (2024) |
| Druh dokumentu: | article |
| ISSN: | 2633-1462 |
| DOI: | 10.1302/2633-1462.58.BJO-2024-0061.R1 |
| Popis: | Aims: Implant waste during total hip arthroplasty (THA) represents a significant cost to the USA healthcare system. While studies have explored methods to improve THA cost-effectiveness, the literature comparing the proportions of implant waste by intraoperative technology used during THA is limited. The aims of this study were to: 1) examine whether the use of enabling technologies during THA results in a smaller proportion of wasted implants compared to navigation-guided and conventional manual THA; 2) determine the proportion of wasted implants by implant type; and 3) examine the effects of surgeon experience on rates of implant waste by technology used. Methods: We identified 104,420 implants either implanted or wasted during 18,329 primary THAs performed on 16,724 patients between January 2018 and June 2022 at our institution. THAs were separated by technology used: robotic-assisted (n = 4,171), imageless navigation (n = 6,887), and manual (n = 7,721). The primary outcome of interest was the rate of implant waste during primary THA. Results: Robotic-assisted THA resulted in a lower proportion (1.5%) of implant waste compared to navigation-guided THA (2.0%) and manual THA (1.9%) (all p < 0.001). Both navigated and manual THA were more likely to waste acetabular shells (odds ratio (OR) 4.5 vs 3.1) and polyethylene liners (OR 2.2 vs 2.0) compared to robotic-assisted THA after adjusting for demographic and perioperative factors, such as surgeon experience (p < 0.001). While implant waste decreased with increasing experience for procedures performed manually (p < 0.001) or with navigation (p < 0.001), waste rates for robotic-assisted THA did not differ based on surgical experience. Conclusion: Robotic-assisted THAs wasted a smaller proportion of acetabular shells and polyethylene liners than navigation-guided and manual THAs. Individual implant waste rates vary depending on the type of technology used intraoperatively. Future studies on implant waste during THA should examine reasons for non-implantation in order to better understand and develop methods for cost-saving. Cite this article: Bone Jt Open 2024;5(8):715–720. |
| Databáze: | Directory of Open Access Journals |
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