在全膝关节整形手术中的骨水泥废物:对范围和成本的初步研究
Geoffrey S Tompkins1, Kevin K Howe1, Rebecca Valderrama2
1Redwood Orthopaedic Surgery Associates, Santa Rosa, CA, USA.
Arthroplasty today
|August 4, 2023
概括
在全膝关节整形术 (TKA) 中,骨水泥废弃物平均为59%,每例费用为129美元. 优化聚甲基甲酸 (PMMA) 的使用可以减少浪费和成本,提高关节置换手术的可持续性.
科学领域:
- 整形外科手术 整形外科手术
- 生物材料科学 生物材料科学
- 医疗保健中的废物管理
背景情况:
- 医疗废物对环境和经济造成重大负担,手术室废物是其中的主要原因.
- 膝关节全关节整形术 (TKA) 的骨质水泥废物以前没有得到量化,尽管进行了大量的水泥化TKA.
- 越来越多的TKA需要对相关的废物流进行调查,例如聚甲基甲酸 (PMMA).
研究的目的:
- 量化在初级TKA过程中产生的骨水泥 (PMMA) 废物的数量和成本.
- 确定影响PMMA废物的因素,包括水泥类型和植入物特性.
- 探索减少PMMA废弃物和TKA中相关成本的策略.
主要方法:
- 评估了商业上可用的普通和 gentamicin 输入的 PMMA 骨的每克产量和成本.
- 收集和测量初级TKA后的残留PMMA,以确定平均废物量和成本.
- 分析了PMMA废物,患者指标和植入物特征之间的潜在相关性.
主要成果:
- 每个TKA的PMMA废物平均为59%,平均成本为每件129美元.
- 与普通水泥相比, Gentamicin 注入的水泥导致废物成本 (2.5倍) 更高.
- 确定了特定的植入物尺寸和表面积范围,这些范围可能允许使用单个40克PMMA包装,减少浪费.
结论:
- 虽然零废物凝固是不切实际的,但在TKA中减少PMMA废物是可以实现和有益的.
- 优化PMMA的使用可以节省大量的成本,并提高关节整形手术的可持续性.
- 重新审视PMMA应用技术有可能减少浪费,而不会影响手术结果或植入物固定.
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