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Can We Avoid Implant-selection Errors in Total Joint Arthroplasty?

Michael P Ast1, David J Mayman, Mathias P Bostrom

  • 1M. P. Ast, Hospital for Special Surgery, New York, NY, USA D. J. Mayman, M. P. Bostrom, A. Gonzalez Della Valle, S. B. Haas, Hospital for Special Surgery, New York, NY.

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Summary
This summary is machine-generated.

Implant selection errors occurred in 0.74% of total hip and knee arthroplasties, despite automated verification. Implementing automated systems can help reduce these common surgical errors.

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Area of Science:

  • Orthopedic surgery
  • Surgical error reduction
  • Medical device management

Background:

  • Implant selection in the operating room is typically manual.
  • Complex compatibility rules and inconsistent labeling contribute to implant selection errors.
  • The efficacy of automated systems for reducing these errors is not well-established.

Purpose of the Study:

  • To determine the frequency of implant selection errors in a high-volume institution.
  • To identify the most common types of implant selection errors in total hip arthroplasty (THA) and total knee arthroplasty (TKA).

Main Methods:

  • Retrospective evaluation of 22,847 primary THA and TKA procedures from 2012-2017.
  • Analysis of an implant log database to identify selection errors.
  • Manual confirmation of system-identified errors by reviewing medical records and implant logs.

Main Results:

  • An automated system identified 169 implant selection errors (0.74% of procedures).
  • Common errors included incorrect side selection, mismatched femoral heads/acetabular liners, and size mismatches.
  • The most frequent error in TKA was a mismatch between the tibial insert and tray.

Conclusions:

  • Automated verification identified a 0.74% error rate in arthroplasties, suggesting underreporting of such errors.
  • Institutions should consider automated verification to decrease operating room implant selection errors.
  • Future multicenter studies are needed to evaluate error prevalence across different healthcare settings.