Mcphillamy Austin, Gurnea Taylor P, Moody Alastair E, Kurnik Christopher G, Lu Minggen
*Bay Street Orthopaedics, Petoskey, MI; †Reno Orthopaedic Clinic, Reno, NV; ‡University of Nevada School of Medicine, Reno, NV; and §Department of Biostatistics, University of Nevada, School of Community Health Sciences, Reno, NV.
J Orthop Trauma. 2016 Dec;30 Suppl 5:S32-S36. doi: 10.1097/BOT.0000000000000721.
In today's climate of cost containment and fiscal responsibility, generic implant alternatives represent an interesting area of untapped resources. As patents have expired on many commonly used trauma implants, generic alternatives have recently become available from a variety of sources. The purpose of this study was to examine the clinical and economic impact of a cost containment program using high quality, generic orthopaedic locking plates. The implants available for study were anatomically precontoured plates for the clavicle, proximal humerus, distal radius, proximal tibia, distal tibia, and distal fibula.
Retrospective review.
Level II Trauma center.
828 adult patients with operatively managed clavicle, proximal humerus, distal radius, proximal tibia, tibial pilon, and ankle fractures.
Operative treatment with conventional or generic implants.
The 414 patients treated with generic implants were compared with 414 patients treated with conventional implants. There were no significant differences in age, sex, presence of diabetes, smoking history or fracture type between the generic and conventional groups. No difference in operative time, estimated blood loss or intraoperative complication rate was observed. No increase in postoperative infection rate, hardware failure, hardware loosening, malunion, nonunion or need for hardware removal was noted. Overall, our hospital realized a 56% reduction in implant costs, an average savings of $1197 per case, and a total savings of $458,080 for the study period.
Use of generic orthopaedic implants has been successful at our institution, providing equivalent clinical outcomes while significantly reducing implant expenditures. Based on our data, the use of generic implants has the potential to markedly reduce operative costs as long as quality products are used.
Therapeutic Level III.
在当今成本控制和财政责任的大环境下，通用型植入物替代品是一个尚未开发的有趣资源领域。由于许多常用创伤植入物的专利已经过期，通用型替代品最近已从多种渠道获得。本研究的目的是探讨使用高质量通用型骨科锁定钢板的成本控制计划的临床和经济影响。可供研究的植入物是锁骨、肱骨近端、桡骨远端、胫骨近端、胫骨远端和腓骨远端的解剖预塑形钢板。
回顾性研究。
二级创伤中心。
828例接受手术治疗的锁骨、肱骨近端、桡骨远端、胫骨近端、胫骨干骺端和踝关节骨折的成年患者。
采用传统或通用型植入物进行手术治疗。
将414例使用通用型植入物治疗的患者与414例使用传统植入物治疗的患者进行比较。通用型组和传统组在年龄、性别、糖尿病患病率、吸烟史或骨折类型方面无显著差异。手术时间、估计失血量或术中并发症发生率无差异。术后感染率、内固定失败、内固定松动、畸形愈合、不愈合或取出内固定的需求均未增加。总体而言，我院在研究期间植入物成本降低了56%，平均每例节省1197美元，总计节省458,080美元。
在我们机构，使用通用型骨科植入物取得了成功，在显著降低植入物支出的同时提供了同等的临床效果。根据我们的数据，只要使用高质量产品，使用通用型植入物有可能显著降低手术成本。
治疗性三级证据。
