ArticleBMJ open quality2019
Health costs and efficiencies of patient-specific and single-use instrumentation in total knee arthroplasty: a randomised controlled trial.
Article in BMJ open quality, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled 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.
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.
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- Should we abandon the patient-specific instrumentation ship in total knee arthroplasty? Not quite yet!BMC musculoskeletal disorders · 2021Pooled it
- Implant contamination as a cause of surgical site infection in spinal surgery: are single-use implants a reasonable solution? - a systematic review.BMC musculoskeletal disorders · 2020Pooled it
- Quality of Online Information on Patient-Specific Knee Arthroplasty and Its Impact on Personalized Care.Clinics and practice · 2025Article
- Outcomes of a Novel Percutaneous Achilles Tendon Repair Technique: A Retrospective Case Series.Cureus · 2025Article
- Innovative 3D printing technologies and advanced materials revolutionizing orthopedic surgery: current applications and future directions.Frontiers in bioengineering and biotechnology · 2025Review
- Does two dimensional templating allow for the use of reduced-size ancillaries in total hip arthroplasty?International orthopaedics · 2024Article
- Three-dimensional-printing-guided preoperative planning of upper and lower extremity pediatric orthopedic surgeries: A systematic review of surgical outcomes.Journal of children's orthopaedics · 2024Review
- Cost-effectiveness of patient specificWorld journal of orthopedics · 2023Article
- Comparative Cost Analysis of Single-use Sterile versus Reprocessed Distal Radius Volar Plate Sets.The archives of bone and joint surgery · 2022Article
- CT-based patient-specific instrumentation for total knee arthroplasty in over 700 cases: single-use instruments are as accurate as standard instruments.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Article
- A novel augmented reality-based surgical guidance system for total knee arthroplasty.Archives of orthopaedic and trauma surgery · 2021Review
- Patient-specific instrumentation combined with a new tool for gap balancing is useful in total knee replacement: a 3-year follow-up of a retrospective study.Journal of orthopaedic surgery and research · 2021Article
- Three-dimensional Printing in Orthopaedic Surgery: Current Applications and Future Developments.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2021Review
- The Accuracy of 3D Printing Assistance in the Spinal Deformity Surgery.BioMed research international · 2019Article
- Three dimensional printing as an aid for pre-operative planning in complex cases of total joint arthroplasty: A case series.Journal of orthopaedicsArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Aim: To 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 methods: Patients 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. Results: PSR 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. Conclusions: PSI 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.
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Registered trials
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.