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Related Concept Videos

Knee Joint01:23

Knee Joint

2.8K
The knee joint is the most complicated joint in the body. It consists of three articulations– two tibiofemoral and one patellofemoral. As is characteristic of synovial joints, the knee joint has a thin articular capsule that partially surrounds this joint cavity. Additionally, several ligaments, muscles, and cartilaginous structures support the movement of the knee.
A total of seven ligaments support the knee joint. The patellar ligament, which is also attached to the quadriceps femoris...
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Reference Pricing Reduces Total Knee Implant Costs.

Christopher J Fang1, Jonathan M Shaker1, Geoffrey E Stoker1

  • 1Department of Orthopedic Surgery, New England Baptist Hospital, Boston, MA.

The Journal of Arthroplasty
|November 15, 2020
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Summary
This summary is machine-generated.

Reference pricing for total knee arthroplasty (TKA) significantly cut implant costs by 16.7%. This cost-saving strategy also increased the use of newer technologies without affecting surgeon choice or vendor relationships.

Keywords:
implant costspractice managementreference pricingtotal joint arthroplasty (TJA)total knee arthroplasty (TKA)vendors

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Area of Science:

  • Orthopedics
  • Health Economics
  • Medical Device Management

Background:

  • Reference pricing sets a fixed hospital payment for total knee arthroplasty (TKA) components.
  • Hospitals contract with vendors at predetermined prices, allowing surgeons clinical freedom.
  • The study hypothesized that vendors would meet reference prices without altering technology selection.

Purpose of the Study:

  • To evaluate the impact of reference pricing on TKA implant costs.
  • To assess changes in implant cost, surgeon volume, cementless TKA utilization, and vendor diversity.
  • To determine if reference pricing affects the adoption of newer technologies.

Main Methods:

  • Retrospective analysis of 7148 TKAs (3790 pre-implementation, 3358 post-implementation).
  • Comparison of implant and component costs before and after reference pricing implementation.
  • Evaluation of cost variations by surgeon volume and changes in cementless TKA rates.

Main Results:

  • Overall implant costs decreased by 16.7% (P < .0001).
  • All component costs reduced by at least 11% (P = .0003).
  • Cementless TKA use increased by 9% (OR 1.94), with no change in vendor numbers or price variation among surgeons.

Conclusions:

  • Reference pricing significantly reduced TKA implant costs.
  • Cost savings were achieved irrespective of surgeon volume.
  • The strategy promoted the adoption of newer technologies and offers a viable cost-saving model for other institutions.