Nele Daemen May 18, 2020

As the COVID-19 situation is starting to stabilize in different parts of the world, a surge of elective procedures is expected in the coming months, including orthopaedic knee surgeries. The amount of osteoarthritic patients in pain waiting for their knee surgery has been growing every day since hospitals around the world have turned most of their resources to treat COVID-19 patients. As such, it will be critical to optimally use the available operating theatres and hospital resources to be able to safely treat as many patients as possible in the months to come. Personalized knee guides hold the potential to reduce costs and treat more patients in a single day. 

Elective procedures potentially account for over 48% of hospital revenues in the US1. Knee arthroplasty is the third most common OR procedure in the US2. Estimates indicate that hospital revenues may fall by $1-2 billion this year (20-40% of their annual total) as they shift from high-revenue surgical and related procedures to caring for increasing numbers of medical inpatients for whom reimbursement is lower3. Healthcare providers and hospitals are currently making plans to restart elective procedures in a safe, and efficient way.

Over ten years ago, Materialise developed the first 3D-printed surgical knee guides, which over the years have proven to allow surgeons to transfer their pre-operative plan accurately and efficiently into the OR4. The predictability that personalized guides enable, can also streamline the OR, reduce costs and treat more patients in a single day.

Up to 75% instrument reduction

The use of 3D pre-operative planning and personalized guides drastically reduces the number of instruments essentially required during surgery. First, by knowing the size of the tibia and femur implants upfront, the size specific instrumentation and trial components can be drastically reduced. Secondly, the traditional instruments necessary for alignment can be reduced to a minimum set that is necessary to perform the procedure, as the guides transfer the pre-operative plans into the OR accurately.

When streamlined optimally, the potential gain can be up to a 75% reduction of instruments5 to be carried into the sterile field of the OR.

Reduced stock and sterilization costs

Reducing the number of surgical trays in the operating theatre, also means reduced number of trays requiring sterilization, therefore reducing sterilization costs6. 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 significantly 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.  
Finally, the skin to skin operative time can be reduced thanks to a reduced number of surgical steps. The surgery time can be reduced up to 13 minutes7, compared to conventional instruments. 

As hospitals and healthcare providers are preparing for the uptake of orthopaedic patients in the post-COVID-19 era, now is a good time to review current practices and streamline patient care without compromising quality of care. Personalized knee guides provide the opportunity to decrease costs per procedure and increase patient turnover.

1The Orthopaedic Forum – Economic impacts of the Covid-19 crisis. An Orthopaedic perspective. Anoushiravani A. 
2https://www.hcup-us.ahrq.gov/reports/statbriefs/sb170-Operating-Room-Procedures-United-States-2011.pdf
3https://hbr.org/2020/03/hospitals-need-cash-health-insurers-have-it 
4Materialise Clinical Evaluation Report
5Depending on the instrument set used. Source:  Zimmer Biomet
6Noble JW., Moore CA. et al (2012) The Value Of Patient-Matched Instrumentation in Total Knee Arthroplasty. The Journal of Arthroplasty 27(1): 153-155 
7Pietsch M., Djahani O.et al (2012) Custom-fit minimally invasive total knee arthroplasty: effect on blood loss and early clinical outcomes. Knee Surgery, Sports Traumatology, and Arthroscopy 36. 
 

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