Intraoperative waste of trauma implants: a cost burden to hospitals worth addressing?

The purposes of this study were to assess the incidence of intraoperative trauma implant waste in a regional territory of the United States and to assess its impact on costs.

The total number of procedures using a single device manufacturer's orthopaedic trauma implants in one geographic region and number of occurrences of intraoperative orthopaedic trauma implant waste were recorded prospectively from 74 contiguous hospitals over a period of 18 months along with the individual responsible for the waste (surgeon, vendor representative, or operating room staff), the cost of the wasted implant, and whether the hospital paid for the implant. Hospitals were stratified into teaching or community institutions. The collected data were then aggregated and analyzed for overall incidence and cost as well as cost per trauma procedure.

Implant waste occurred in 37 of 6531 procedures (0.6%) with 16 of the centers (21.6%) reporting at least one occurrence and 95% attributed to the surgeon or operating room staff. Community hospitals were found to have a significantly higher incidence of implant waste as compared with teaching hospitals. Hospitals absorbed 74% of the wasted implant costs ($20,357 over the study period). This expense represented a mean additional cost of $3.12 per orthopaedic trauma procedure performed.

There is a small but notable annual incidence and cost of orthopaedic trauma implant waste in the study region with the majority of this cost borne by the hospitals. However, implant waste occurs infrequently and represents a very small cost to hospitals per procedure. Educational programs and other strategies to reduce its incidence are unlikely to yield any substantial cost savings.