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首页> 外文期刊>Foot & Ankle Orthopaedics >Comparison of Time and Cost Savings Using Different Cost Methodologies for Patient-Specific Instrumentation vs Standard Referencing in Total Ankle Arthroplasty
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Comparison of Time and Cost Savings Using Different Cost Methodologies for Patient-Specific Instrumentation vs Standard Referencing in Total Ankle Arthroplasty

机译：使用不同成本方法对患者特定仪器的时间和成本节约的比较VS标准参考总踝关节造身术

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Background: Patient-specific 3-D printing cutting blocks (PSI) have been used instead of traditional intramedullary cutting guides. We hypothesized that PSI would lead to significantly decreased operating room (OR) time and significant cost savings to our institution with noninferior radiographic outcomes and no difference in expected vs actual implant size when compared with standard referencing (SR). Methods: Patients who had undergone total ankle replacements at our institution from 2013 through 2016 were included in the study. Associations between demographic variables and postoperative alignment in the SR vs PSI group were calculated using the Wilcoxon rank-sum test and the intraclass correlation coefficient. The cost of the operation was calculated using both an institutionally based fixed cost of OR time and using Time Driven Activity Based Cost (TDABC) accounting. A total of 43 patients were included in the study, 13 in the SR group and 30 in the PSI group. Results: Operative time (168 vs 137 minutes) and tourniquet time (123 vs 113 minutes) were significantly lower in the PSI vs the SR group. PSI predictions were accurate 100% of the time for tibial components and 83% of the time for talar components. Average costs of TAA using PSI were significantly reduced by $7597.00 when using traditional OR accounting, whereas PSI was $836.00 more expensive on average using TDABC accounting. Conclusion: Further research is needed to determine the cost-effectiveness of PSI vs SR in TAA; however, it does appear to save time intraoperatively. The long-term effect on clinical outcomes requires further study. Level of Evidence: Level III, case-control study.
机译：背景：已使用特异性患者的3-D印刷切割块（PSI）代替传统的髓内切割导轨。我们假设PSI将导致手术室（或）的时间（或）时间和大量成本节省在与非流学射线显影结果中，并且与标准参考（SR）相比，预期的VS实际植入大小没有差异。方法：在2013年至2016年从2016年到2016年在2013年到2016年经过踝关节替代的患者均纳入该研究。使用Wilcoxon Ranku-Sum测试和跨周性相关系数计算SR VS PSI组中人口变量与术后对准的关联。使用机构基于的固定成本或时间和基于时间驱动的活动（TDABC）会计计算来计算操作成本。共有43名患者纳入研究中，13例在SR组中，30例在PSI组中。结果：PSI对SR组的操作时间（168 vs 137分钟）和止血带时间（123 vs 113分钟）显着降低。 PSI预测是胫骨部件100％的时间和缩略图组分的83％的时间。使用传统或会计时，使用PSI的TAA的平均成本明显减少了7597.00美元，而使用TDABC会计，PSI平均昂贵836.00美元。结论：需要进一步研究，以确定TAA中PSI与SR的成本效益;但是，它似乎确实节省了术中的时间。对临床结果的长期影响需要进一步研究。证据水平：第三级，病例对照研究。

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