Evidence map›Paper›PMID 30723638›Full record

ArticleCureus2018

Cement Waste During Primary Total Knee Arthroplasty and its Effect on Cost Savings: An Institutional Analysis.

James R Yan, Stephan Oreskovich, Kayode Oduwole, Nolan Horner, Vickas Khanna, Anthony Adili

Abstract read
In one paragraph

Article in Cureus, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

James R YanOrthopaedics, McMaster University, Hamilton, CAN.
Stephan OreskovichOrthopaedics, McMaster University, Hamilton, CAN.
Kayode OduwoleOrthopaedics, McMaster University, Hamilton, CAN.
Nolan HornerOrthopaedics, McMaster University, Hamilton, CAN.
Vickas KhannaOrthopaedics, McMaster University, Hamilton, CAN.
Anthony AdiliOrthopaedics, McMaster University, Hamilton, CAN.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose Healthcare costs are increasingly garnering more media attention and there is increasing focus on improving efficiencies in daily practice. Orthopedic surgery is also subject to these fiscal pressures, particularly in arthroplasty surgeries, secondary to high volumes with costly equipment. Total knee arthroplasties (TKA) are one of the most common surgical procedures, with over 64,000 annual cases in Canada. Even marginal cost reductions per procedure can be compounded over the large volume to result in considerable savings. This study's purpose is to investigate and quantify the cost of wasted intraoperative cement used in primary TKA. Methods Residual amounts of wasted bone cement were collected and measured following uncomplicated primary TKAs performed by the senior authors in a high-volume arthroplasty centre between January and June 2017. Stryker Simplex® with Tobramycin Bone Cement was the specific institutional cement used. Results One hundred and two primary total knee arthroplasties were investigated. The results revealed that an average 91.2 g of surgical cement was wasted per case, with less than 30 g retained in the bone-implant interface (26.8 g). Institutional costs per package of cement is $120.62, amounting to $2.04 per gram of cement. This represents a value of $186.25 CAD per case. Conclusion On average, each primary TKA procedure wastes 91.2 g of bone cement per case. The value of this wasted cement is $186.25 CAD per TKA. When extrapolated to the most recent recorded numbers of TKAs done in Canada, that figure nears $12 million. The results of this study are important, as they reveal a potential source to target for both waste reduction and cost control.

Indexed as

arthroplastycost evaluationhealth economicskneewaste

Identifiers

PMID30723638
PMCPMC6351001

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.