Impact of change of knee prosthesis on early clinical outcomes in a large volume arthroplasty centre.

Annals of the Royal College of Surgeons of England

PubMedID: 24165339

Moonot P, D'Mello O, Tzinga N, Sisak K, Fiddian NJ, Harvey AH. Impact of change of knee prosthesis on early clinical outcomes in a large volume arthroplasty centre. Ann R Coll Surg Engl. 2013;95(8):573-6.
INTRODUCTION
The aim of our study was to investigate the effect of changing the default knee prosthesis in a high volume dedicated arthroplasty unit from DePuy's PFC(®) Sigma(®) to Smith & Nephew's Genesis™ II.

METHODS
A retrospective analysis was performed of prospective data on primary total knee replacements (TKRs) from January 2009 until December 2011. This provided information on the operative time, length of stay, pain at mobilisation, radiography analysis, any complications, and readmission at 30 and 60 days. RESULTSThe total numbers of primary TKRs using the PFC(®) and Genesis™ II prostheses were 1,061 and 1,268 respectively. The results showed a slight increase (maximum of five minutes) in the operative time for all the surgeons except one surgeon, whose operative time reduced by an average of seven minutes. There was no significant adverse outcome after the change in the knee implant. There was no clinically significant increase in the length of stay, pain at mobilisation or complication rates. There was a twofold increase in the wastage of the implant in the Genesis™ II group in the initial learning period.

CONCLUSIONS
Through a competitive process of implant tendering, we have successfully introduced a new implant into a large elective orthopaedic unit. This has resulted in significant financial savings without adversely affecting our clinical practice or patient outcome.