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The steadily increasing demand for orthopedic surgeries and declining rates of reimbursement by Medicare and other insurance providers have led many hospitals to look for ways to control the cost of these surgeries. We reviewed administrative records for a 1-year period and recorded total number of surgical cases, number of cases in which an implant was wasted, and cost of each wasted implant. We determined cost incurred because of implant waste, percentage of cases that involved waste, percentage of total implant cost wasted, and average cost of waste per case. We then analyzed the data to determine if case volume or years in surgical practice affected amount of implant waste. Results showed implant waste represents a significant cost for orthopedic procedures within all subspecialties and is an important factor to consider when developing cost-reduction strategies.

Hospital readmissions are quality indicators of healthcare delivery. Our purpose is to examine the effect of a program designed to reduce readmissions after total joint replacement. We initiated a comprehensive program with 4 goals: (1) outpatient workup of venous thromboembolism; (2) decrease surgical site infection; (3) early follow-up with primary care physicians; and (4) increase physician awareness of the financial and quality-related ramifications of unplanned readmissions. We then compared readmission rates before our initiative was instituted (2005-2006) to 3 years after implementation (2007-2009). Readmission rates preintervention were 3.70 and 3.29 for total hip replacement (THR) and knee replacement (TKR), respectively. Postintervention rates fell to 1.78 and 1.98, respectively, representing a 47.2% reduction of readmission for THR and 39.8% for TKR (P.05). These results demonstrate the success of our program in reducing readmissions. This may result in reductions in healthcare costs and improvement in quality of care.