Surgeons' Perspectives on Premium Implants in Total Joint Arthroplasty

Area of Science:

• Orthopedic surgery
• Medical device economics
• Healthcare policy

Background:

• Declining reimbursement and rising implant costs impact hospital access to advanced total joint arthroplasty implants.
• Hospitals are increasingly restricting the use of newer, more expensive implants.
• Understanding surgeon perspectives on implant innovation, cost, and payment models is crucial.

Purpose of the Study:

• To investigate arthroplasty surgeons' views on implant innovation, product launches, and costs.
• To explore surgeon attitudes towards cost-containment strategies like gain-sharing and patient cost-sharing.
• To identify factors influencing surgeon support for different payment models and implant selection autonomy.

Main Methods:

• A survey was distributed to members of the International Congress for Joint Reconstruction.
• 126 arthroplasty surgeons across the United States responded.
• Descriptive and univariate statistical analyses were performed on the survey data.

Main Results:

• A majority (76.9%) believe new orthopedic products advance technology.
• Most surgeons (66.7%) support informing patients about the lack of long-term data for new implants and restricting their initial use.
• Two-thirds (66.7%) would forgo gain-sharing for greater implant choice freedom; 76.9% support patient cost-sharing for premium implants.

Conclusions:

• Arthroplasty surgeons value technological advancement but advocate for transparency regarding the clinical evidence of new implants.
• Surgeons support alternative payment models that preserve autonomy in implant selection for both patients and themselves.
• The findings suggest a prioritization of patient beneficence and surgeon autonomy over personal financial gain in implant decision-making.