Strategies for reducing implant costs in the revision total knee arthroplasty episode of care

Background: Implant price has been identified as a significant contributing factor to high costs associated with revision total knee arthroplasty (rTKA). The goal of this study is to analyze the cost of implants used in rTKAs and to compare this pricing with 2 alternative pricing models. Methods: Using our institutional database, we identified 52 patients from January 1, 2014 to December 31, 2014. Average cost of components for each case was calculated and compared to the total hospital cost for that admission. Costs for an all-component revision were then compared to a proposed âdirect to hospitalâ (DTH) standardized pricing model and a fixed price revision option. Potential savings were calculated from these figures. Results: On average, 28% of the total hospital cost was spent on implants for rTKA. The average cost for revision of all components was $13,640 and ranged from $3000 to $28,000. On average, this represented 32.7% of the total hospital cost. Direct to hospital implant pricing could potentially save approximately $7000 per rTKA, and the fixed pricing model could provide a further $1000 reduction per rTKAâpotentially saving $8000 per case on implants alone. Conclusions: Alternative implant pricing models could help lower the total cost of rTKA, which would allow hospitals to achieve significant cost containment. Keywords: Total knee arthroplasty, Revision knee arthroplasty, Medicare, Fee-for-service, Direct to hospital, Fixed price