Orthopedic Implant Waste: Analysis and Quantification
The steadily increasing demand for orthopedic surgeries and declining rates of reimbursement by Medicare and other insurance providers have led many hospitals to look for ways to control the cost of these surgeries.
We reviewed administrative records for a 1-year period and recorded total number of surgical cases, number of cases in which an implant was wasted, and cost of each wasted implant. We determined cost incurred because of implant waste, percentage of cases that involved waste, percentage of total implant cost wasted, and average cost of waste per case. We then analyzed the data to determine if case volume or years in surgical practice affected amount of implant waste.
Results showed implant waste represents a significant cost for orthopedic procedures within all subspecialties and is an important factor to consider when developing cost-reduction strategies.
Conclusions
Our study demonstrated significant costs related to implant waste. These costs are important to consider not only for traditional cases, such as total joint and spine procedures, in which implant costs are routinely scrutinized, but for all subspecialties, such as sports medicine, in which the majority of cases are performed on an outpatient basis. Considering the estimated $36 million wasted during THAs and TKAs and $126 million wasted on spine surgeries in the United States annually, and the significant waste we observed in other orthopedic subspecialties, decreasing the rate of intraoperative waste during orthopedic surgeries represents another area that could provide significant cost reduction through implant cost savings.19,22 A few successful programs have been reported. Soroceanu and colleagues22 found an almost 50% decrease in intraoperative waste during spine surgery after an educational program was used to address such waste. Elsewhere, use of a computer-based system (e.Label and Compatibility) led to an estimated cost reduction of $75,000 in implant waste.25 Efforts to develop and implement other programs to reduce implant waste are needed and should be part of any orthopedic operating room cost reduction strategy.
