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Are All Hardware Removals Equal?

Jesse M Galina1, Vishal Sarwahi1, Aaron M Atlas1

  • 1Department of Pediatric Orthopaedics, Cohen Children's Medical Center, Northwell Health System, New Hyde Park, New York.

Journal of Surgical Orthopaedic Advances
|April 14, 2021
PubMed
Summary
This summary is machine-generated.

Surgeon compensation varies significantly based on implant removal type. This study found that longer operative times for certain implants, like long plates, result in lower relative value units per minute, impacting reimbursement.

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Area of Science:

  • Orthopaedic Surgery
  • Surgical Outcomes Analysis
  • Healthcare Economics

Background:

  • Accurate assessment of operative time and associated reimbursement is crucial for surgical practice management.
  • Previous studies have not comprehensively compared the efficiency and financial return of removing various orthopaedic implant types.

Purpose of the Study:

  • To analyze operative time and complications for six distinct implant removal types.
  • To evaluate surgeon compensation efficiency, measured by relative value units (RVU) per minute, for these removals.

Main Methods:

  • Retrospective analysis of 392 hardware removals between 2014-2019.
  • Data collected included patient demographics, operative time, blood loss, complications, and RVU/min.
  • Comparison of RVU/min across flexible nails, intramedullary rigid nails, long plates, screws, single guided-growth plates, and multiple guided-growth plates.

Main Results:

  • Long plate removals were significantly longer and yielded lower RVU/min compared to screw and guided-growth plate removals (p < 0.001).
  • Intramedullary nail removals took longer than flexible nails, with nearly double the RVU/min (p = 0.02).
  • Significant disparities in RVU/min were observed among the six implant types.

Conclusions:

  • The financial compensation efficiency (RVU/min) is not uniform across different orthopaedic implant removal procedures.
  • Surgeons can leverage this data to optimize scheduling for maximum practice utilization.
  • This study provides valuable insights for fair reimbursement and efficient surgical practice management.