Cement Waste During Primary Total Knee Arthroplasty and its Effect on Cost Savings: An Institutional Analysis
Bibliographic record
Abstract
Purpose Healthcare costs are increasingly garnering more media attention and there is increasing focus on improving efficiencies in daily practice. Orthopedic surgery is also subject to these fiscal pressures, particularly in arthroplasty surgeries, secondary to high volumes with costly equipment. Total knee arthroplasties (TKA) are one of the most common surgical procedures, with over 64,000 annual cases in Canada. Even marginal cost reductions per procedure can be compounded over the large volume to result in considerable savings. This study's purpose is to investigate and quantify the cost of wasted intraoperative cement used in primary TKA. Methods Residual amounts of wasted bone cement were collected and measured following uncomplicated primary TKAs performed by the senior authors in a high-volume arthroplasty centre between January and June 2017. Stryker Simplex® with Tobramycin Bone Cement was the specific institutional cement used. Results One hundred and two primary total knee arthroplasties were investigated. The results revealed that an average 91.2 g of surgical cement was wasted per case, with less than 30 g retained in the bone-implant interface (26.8 g). Institutional costs per package of cement is $120.62, amounting to $2.04 per gram of cement. This represents a value of $186.25 CAD per case. Conclusion On average, each primary TKA procedure wastes 91.2 g of bone cement per case. The value of this wasted cement is $186.25 CAD per TKA. When extrapolated to the most recent recorded numbers of TKAs done in Canada, that figure nears $12 million. The results of this study are important, as they reveal a potential source to target for both waste reduction and cost control.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".