Disposable instruments in total knee arthroplasty

Abstract

The number of total knee arthroplasty (TKA) procedures continues to increase in United States, with over half a million performed each year [1] and an expectation that this number will increase by 600% to three million a year by 2030 [2]. As the volume of TKA increases, hospitals and surgeons need to be able to perform these procedures with greater efficiency. These changes in efficiency must maintain or improve quality. Although the majority of TKA procedures are performed successfully, the risk of periprosthetic infections secondary to contamination of surgical instruments or the surgical field remains a concern to orthopedic surgeons. Although the risk of deep infection remains approximately 1% in primary TKA [3], such complications are devastating in terms of the morbidity they cause patients. Furthermore, new legislation has determined that bacterial contamination is a “preventable” complication, requiring treatment that is not reimbursed [4]. Consequently, reimbursement rates are declining to both institutions and orthopedic surgeons, creating additional pressure on surgeons to provide operative care that must be increasingly efficient, yet less expensive. A novel approach aimed at decreasing the risk of contamination while improving efficiency involves disposable instruments, cutting blocks, and trials to perform TKA.