Single-Use Instruments, Cutting Blocks, and Trials Increase Efficiency in the Operating Room During Total Knee Arthroplasty

2013 ◽  
Vol 28 (7) ◽  
pp. 1135-1140 ◽  
Author(s):  
Michael A. Mont ◽  
Mark J. McElroy ◽  
Aaron J. Johnson ◽  
Robert Pivec
Keyword(s):  
Total Knee Arthroplasty ◽  
Operating Room ◽  
Knee Arthroplasty ◽  
Total Knee ◽  
Single Use ◽  
Increase Efficiency

scholarly journals Health costs and efficiencies of patient-specific and single-use instrumentation in total knee arthroplasty: a randomised controlled trial

2019 ◽  
Vol 8 (2) ◽  
pp. e000493 ◽  
Author(s):  
Andre Attard ◽  
Gwenllian Fflur Tawy ◽  
Michiel Simons ◽  
Philip Riches ◽  
Philip Rowe ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Healthcare Provider ◽  
Operating Room ◽  
Knee Arthroplasty ◽  
Patient Specific ◽  
Potential Cost ◽  
Time Intervals ◽  
Total Knee ◽  
Single Use

AimTo investigate whether patient-specific instrumentation (PSI) and single-use instrumentation (SUI) improve operating room efficiency in terms of time and cost to the healthcare provider over conventional/reusable instrumentation (CVR) when performing total knee arthroplasty (TKA).Patients and methodsPatients requiring TKA were randomised into one of four surgical groups: CVR, CVS (conventional/SUI), PSR (PSI/reusable) and PSS (PSI/SUI). All surgical procedures were video recorded to determine specific surgical time intervals. Other variables reported included the number of instrument trays used, missing equipment, direct instrument costs and the weight of the instruments the staff had to handle. Oxford Knee Score (OKS), estimated blood loss and lengths of hospital stay were also recorded as markers of patient experience.ResultsPSR was significantly quicker in all the recorded time intervals, used less trays, experienced less missing equipment and resulted in lower blood loss and shorter hospital stays. SUI reported significantly slower operating room times and resulted in higher blood loss, but SUI was 88% lighter and 20% cheaper on average when compared with their reusable counterparts. Despite the economic advantages of PSI and SUI, the patients who reported greatest improvements in OKS were those allocated to the CVR group, but no clinically meaningful difference in OKS was found at any time point.ConclusionsPSI and SUI for TKA have the potential of reducing operating room times over conventional, reusable sets. This reduction will benefit theatre personnel ergonomically, while presenting the healthcare provider with potential cost-saving benefits in terms of reduced sterilisation costs and surgical times.

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

2019 ◽  
Vol 34 (9) ◽  
pp. 1876-1883.e2 ◽  
Author(s):  
Tyler D. Goldberg ◽  
John A. Maltry ◽  
Mukesh Ahuja ◽  
Jason A. Inzana
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Total Knee ◽  
Single Use

scholarly journals Does the use of Robotic Technology Improve Surgeon Ergonomic Safety during TKA?

10.29007/xjjm ◽  
2019 ◽  
Author(s):  
Laura Scholl ◽  
Emily Hampp ◽  
Vincent Alipit ◽  
Antonia Chen ◽  
Michael Mont ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
High Risk ◽  
Operating Room ◽  
Knee Arthroplasty ◽  
Overuse Injuries ◽  
Robotic Technology ◽  
Robotic Assisted ◽  
Work Related ◽  
Lower Back ◽  
Total Knee

Surgeon physical stress in the operating room is a known potential cause of musculoskeletal overuse injuries, specifically in surgeons who perform total knee arthroplasty (TKA). Injuries have been attributed to ergonomically challenging postures. This study compared surgeon lower back and shoulder posture between manual TKA (MTKA) and robotic assisted TKA (RATKA).Two surgeons performed a total six MTKA and six RATKA on a set of cadaveric knees. Movement and EMG sensors were secured to each surgeon to monitor lower back and shoulder movements, as well as muscle activities. Data was analyzed and activities were assessed as low, medium, or high risk, providing a score between 0-lowest and 16-highest. Risk data was compared between MTKA and RATKA for three separate surgical tasks: 1-bone cut preparation & cutting (MTKA = placement of cutting jigs, bone cutting, RATKA = array placement, bone registration, bone cutting), 2-knee balancing and 3-trialing.Overall, there were more high-risk shoulder than lower back activities in MTKA and RATKA. More high-risk movement and EMG stimulation were measured in the dominant shoulder than the non-dominant. When lower back and shoulder data were combined, highest risk task was bone cut preparation & cutting (MTKA: 13 vs. 6 vs. 6 and RATKA: 11 vs. 8 vs. 6), with a higher risk for MTKA than RATKA.Poor posture can be a potential cause for surgeon work-related injuries. This study evaluated which tasks presented highest risk to surgeon ergonomic safety while performing TKA, and found lower overall ergonomics risk for performing RATKA vs. MTKA. Although this study provides data indicating reduced ergonomic risk with RATKA, additional studies in the operating room need to be performed.

Feasibility of single-use 3D-printed instruments for total knee arthroplasty

2019 ◽  
Vol 101-B (7_Supple_C) ◽  
pp. 115-120 ◽  
Author(s):  
J. Hooper ◽  
R. Schwarzkopf ◽  
E. Fernandez ◽  
A. Buckland ◽  
J. Werner ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Acrylonitrile Butadiene Styrene ◽  
Dimensional Changes ◽  
Before And After ◽  
Nylon 12 ◽  
3D Printed ◽  
Total Knee ◽  
Single Use ◽  
Oscillating Saw

Aims This aim of this study was to assess the feasibility of designing and introducing generic 3D-printed instrumentation for routine use in total knee arthroplasty. Materials and Methods Instruments were designed to take advantage of 3D-printing technology, particularly ensuring that all parts were pre-assembled, to theoretically reduce the time and skill required during surgery. Concerning functionality, ranges of resection angle and distance were restricted within a safe zone, while accommodating either mechanical or anatomical alignment goals. To identify the most suitable biocompatible materials, typical instrument shapes and mating parts, such as dovetails and screws, were designed and produced. Results Before and after steam sterilization, dimensional analysis showed that acrylonitrile butadiene styrene could not withstand the temperatures without dimensional changes. Oscillating saw tests with slotted cutting blocks produced debris, fractures, or further dimensional changes in the shape of Nylon-12 and polymethylmethacrylate (MED610), but polyetherimide ULTEM 1010 was least affected. Conclusion The study showed that 3D-printed instrumentation was technically feasible and had some advantages. However, other factors, such as whether all procedural steps can be accomplished with a set of 3D-printed instruments, the logistics of delivery, and the economic aspects, require further study. Cite this article: Bone Joint J 2019;101-B(7 Supple C):115–120

Single-Use Custom Instrumentation in Total Knee Arthroplasty: Effect on In-Hospital Complications, Length of Stay, and Discharge Disposition

Orthopedics ◽  
2019 ◽  
Vol 42 (5) ◽  
pp. 299-303
Author(s):  
Ryan E. Harold ◽  
Jonathan Macleod ◽  
Bennet A. Butler ◽  
Ryan Sullivan ◽  
Matthew D. Beal ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Length Of Stay ◽  
Knee Arthroplasty ◽  
Discharge Disposition ◽  
Total Knee ◽  
Single Use ◽  
Custom Instrumentation

Cost Analysis and Surgical Site Infection Rates in Total Knee Arthroplasty Comparing Traditional vs. Single-Use Instrumentation

2015 ◽  
Vol 30 (12) ◽  
pp. 2271-2274 ◽  
Author(s):  
Geoffrey W. Siegel ◽  
Neil N. Patel ◽  
Michael A. Milshteyn ◽  
David Buzas ◽  
Daniel J. Lombardo ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Cost Analysis ◽  
Surgical Site Infection ◽  
Knee Arthroplasty ◽  
Site Infection ◽  
Infection Rates ◽  
Total Knee ◽  
Single Use
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