Nele Daemen October 27, 2021


How Knee Guides Can Maximize Surgical Efficiency in Ambulatory Centers

A growing number of knee patients and increasing financial pressure are placing hospitals and ambulatory surgery centers (ASCs) under enormous pressure to balance costs while maintaining the best treatment for each patient. As such, it is critical to optimally use the available operating theatres and hospital resources to safely treat as many patients as possible at an acceptable cost. Personalized knee guides hold the potential to reduce costs and treat more patients in a single day without additionally burdening the hospital’s staff.

The shift of knee procedures from regular hospitals to ASCs has accelerated since Medicare and Medicaid favorably changed the reimbursement landscape.

The number of hip and knee joint replacement surgeries performed in an outpatient setting is expected to grow 73% from approximately 1.1 million today to about 1.9 million by 2026 (1.28 million knees + 620.000 hips)i,ii.

Optimizing the total cost of treatment while keeping the same high-quality standard of care will be critical to enable this shift to ASCs further. Many ASCs are currently being challenged in achieving this balance due to a lack of processes and tools that can help them increase efficiency.

Over the past ten years, 3D-printed surgical knee guides have been widely adopted by surgeons worldwide to transfer their pre-operative plan accurately and efficiently into the operating room (OR)iii. The predictability that personalized guides enable can also help streamline the OR, reduce costs, and treat more patients in a single day.


The surgery time can be reduced up to 13 minutesiv with knee guides when compared to using only conventional instruments.

Up to 75% instrument reduction

3D pre-operative planning and personalized guides significantly reduce the number of essential instruments required during surgery.

 3D-printed knee guides on a tray along with other surgical tools in preparation for an operation.

3D-printed knee guides along with surgical tools in the OR

First, by knowing the size of the tibia and femur implants upfront, size-specific instrumentation and trial components can be drastically reduced. Secondly, the traditional instruments necessary for alignment can be reduced to a minimum set, as the guides will accurately transfer the pre-operative plan and alignment into the OR.

When optimally streamlined, the potential gain can be up to a 75% reduction of instrumentsv needed in the sterile field of the OR.

Reduced stock and sterilization costs

Reducing the number of surgical trays in the operating theatre also means reducing sterilization costsvi. As less stock is required for each surgery, hospital stock and logistics can also be optimized, leading to cost savings.

Increased OR efficiency

This instrument optimization holds the potential to accelerate the OR set-up and turnover time. Additionally, this alleviates the workload for the circulating nurse and OR nurses drastically, as they need to handle and carry less equipment.


Hands holding personalized knee guide

Finally, the skin-to-skin operative time can be reduced thanks to fewer surgical steps. The surgery time can be reduced up to 13 minutesvii, compared to when using only conventional instruments.

As the list of ASC-qualified procedures keeps expanding and demographics increase, more patients will be treated in an ambulatory surgical center in the years to come. ASCs that want to profit from this inflow must be well-prepared by reviewing current practices and streamlining procedures. 3D surgical planning and personalized guides are easily accessible technologies that any ASC looking to optimize procedures while keeping high-quality standards of care can successfully and sustainably adopt.






Ⅲ Materialise Clinical Evaluation Report

Ⅳ Pietsch M., Djahani al (2012) Custom-fit minimally invasive total knee arthroplasty: effect on blood loss and early clinical outcomes. Knee Surgery, Sports Traumatology, and Arthroscopy 36. 

Ⅴ Depending on the instrument set used. Source:  Zimmer Biomet

Ⅵ Noble JW., Moore CA. et al (2012) The Value Of Patient-Matched Instrumentation in Total Knee Arthroplasty. The Journal of Arthroplasty 27(1): 153-155 

Ⅶ Pietsch M., Djahani al (2012) Custom-fit minimally invasive total knee arthroplasty: effect on blood loss and early clinical outcomes. Knee Surgery, Sports Traumatology, and Arthroscopy 36.

Gain OR Efficiency with Knee Guides

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