From the Department of Orthopaedic Surgery, TRIA Orthopedic Center, Bloomington, MN (Dr. Kleinsmith, Dr. Doxey, Dr. Huyke, and Dr. Cunningham), and the Department of Orthopaedic Surgery, Methodist Hospital, St. Louis Park, MN (Dr. Kleinsmith, Dr. Doxey, Dr. Huyke, and Dr. Cunningham).
J Am Acad Orthop Surg Glob Res Rev. 2024 Mar 5;8(3). doi: 10.5435/JAAOSGlobal-D-23-00186. eCollection 2024 Mar 1.
This study aims to compare 90-day and 6-month outcomes and implant costs of intertrochanteric and subtrochanteric fracture fixation using cephalomedullary nails (CMNs) from a single name-brand company to fixation using generic CMNs. This was a retrospective matched cohort study. All CMN procedures for a single surgeon in a single US metropolitan institution from 2021 to 2022 were identified using current procedural terminology codes. Nearest neighbor 1:1 matching was conducted between the name-brand and generic cohorts controlling for (1) age, (2) American Society of Anesthesiologists score, and (3) Charlson Comorbidity Index. A total of 50 patients were successfully matched (25 namebrand versus 25 generic). The average implant cost per case for the name-brand group was $3,587 versus $1,615 for the generic group. Cost of disposables averaged $109 for the generic implant sets versus $916 for the name-brand (P < 0.001). Overall, a cost savings of 61% could be generated per case with the use of generic implants and disposables. Fixation of intertrochanteric and subtrochanteric fractures using generic CMNs produces similar outcomes compared with using name-brand CMNs for approximately half the implant cost.
本研究旨在比较使用单一品牌公司的股骨近端髓内钉（CMN）与使用通用 CMN 固定转子间和转子下骨折的 90 天和 6 个月的结果和植入物成本。这是一项回顾性匹配队列研究。使用当前操作术语代码，确定了 2021 年至 2022 年一位美国大都市机构的单一外科医生的所有 CMN 手术。对品牌和通用队列进行了 1:1 的最近邻居匹配，控制因素包括（1）年龄、（2）美国麻醉师协会评分和（3）Charlson 合并症指数。共有 50 名患者成功匹配（25 名品牌组和 25 名通用组）。品牌组的每个病例平均植入物成本为 3587 美元，而通用组为 1615 美元。通用植入物组的一次性器械费用平均为 109 美元，而品牌组为 916 美元（P<0.001）。总体而言，使用通用植入物和一次性器械可使每个病例的成本节省 61%。使用通用 CMN 固定转子间和转子下骨折的效果与使用品牌 CMN 相似，植入物成本约为其一半。
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