Abstract
INTRODUCTION
Wasted implants represent both an increased risk and cost to our healthcare system. In our institution, a sterilely packaged implant that is opened and not implanted is wasted in one out of 20 primary total knee replacement procedures. The cost of these wasted implants exceeds $1 million per year. We propose the introduction of a novel, computer based, e.Label and compatibility system to reduce implant-related medical errors and waste in total knee arthroplasty. We hypothesize that the implementation of this system will help reduce medical errors and wasted implants by improving and standardizing the visual markers and by ensuring that parts are compatible so that implant mismatches and inappropriate laterality are prevented.
METHODS
A software program was implemented which creates an e.Label for all components (Figure 1) and checks imbedded, manufacturer provided, compatibility charts to ensure that parts are of appropriate laterality, and are compatible with each other. Upon implementation, the program was studied prospectively for seven months and compared to a retrospective cohort in regards to number, type, and cost of wasted implants. Critical errors that were detected were also recorded.
RESULTS
During the retrospective period there were 83 wasted implants in 1450 surgeries, or an incidence of 5.7%. After implementation of the computer based system, there were two wasted implant in 244 surgeries performed by the study physicians, or an incidence of 0.8% (Figure 2). One critical medical error was identified and prevented during the study period (Figure 3). The annualized cost savings from this decrease in wasted implants was over $200,000 among our six study surgeons.
CONCLUSION
The introduction of this system was able to prevent at least one serious medical error, while dramatically decreasing the number and cost of wasted implants in our institution. Implementation on a larger scale may provide potential for safer, more efficient, and more cost-effective orthopaedic care.
