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Study: iTotal® CR Offers Potential for Economic Savings

In an independent, prospective, single-center investigator-initiated study of 62 total knee replacement patients in “fast track” surgeries, those who received an iTotal® CR had significantly better outcomes compared to patients who received a traditional “off-the-shelf” implant. Specifically, iTotal® CR patients had a significantly shorter length of stay than off-the-shelf patients (1.6 days vs. 2.7 days, p=0.004). Additionally, a higher proportion of iTotal® CR patients were discharged within 24 hours (66% vs. 30%, p=0.006) with a significantly higher proportion of iTotal® patients discharged directly to home (97% vs. 80%, p=0.0496) as opposed to a skilled nursing facility. Further, a significantly higher proportion of iTotal® patients were able to achieve range of motion greater than or equal to 120˚ (84% vs. 45%, p=0.003). This study was presented at the 2016 ICJR Pan Pacific Orthopaedic Congress.

Based on the results of the study and other published economic data, Dr. Buch concluded that ConforMIS iTotal® CR has the potential to save hospitals approximately $2,200 per patient. The recent rollout of the Comprehensive Care for Joint Replacement (CJR) model has incentivized hospitals to better manage costs and care coordination for knee replacement patients. Under the CJR model, which has been implemented in 67 Metropolitan Statistical Areas, the Centers for Medicare & Medicaid Services (CMS) has a stated goal of saving $150 million over 5 years. Two of the most costly components across the entire episode of care for total knee replacements are the initial inpatient hospital stay and the use of rehabilitation facilities after discharge. Based on a previously published cost analysis of length of stay1, by shortening the average length of hospital stay by 1.1 days compared with off-the-shelf implants, Dr. Buch concluded that there is potential for in-hospital cost savings of approximately $1,100 per patient. Similarly, based on another previously published cost analysis of discharge destination2, Dr. Buch concluded that a lower proportion of iTotal® patients being discharged to skilled nursing facilities has the potential for an additional savings of approximately $1,100 per patient for a total potential savings of approximately $2,200 per patient.

1: S.J. Barad, et al., Is a shortened length of stay and increased rate of discharge to home associated with a low readmission rate and cost-effectiveness after primary total knee arthroplasty?, Arthroplasty Today (2015), http://dx.doi.org/10.1016/j.artd.2015.08.003

2: Ramos NL, et al, Correlation Between Physician Specific Discharge Costs, LOS, and 30-day Readmission Rates: An Analysis of 1,831 cases, J Arthroplasty (2014), http://dx.doi.org/10.1016/j.arth.2014.04.005


Does Implant Design Affect Hospital Metrics and Patient Outcomes? TKA Utilizing a “Fast Track” Protocol

Important Safety Information

The iTotal CR Knee Replacement Systems are intended for use as a total knee replacement in patients with knee joint pain and disability whose conditions cannot be solely addressed by the use of a prosthetic device that treats only one or two of the three knee compartments, such as a unicondylar, patellofemoral or bicompartmental prosthesis. Only a licensed physician can help you determine the appropriate medical treatment. There are potential risks to knee replacement surgery, and individual results may vary. Before making any decisions concerning medical treatment, consult your physician regarding your options and the risks of those options. The longevity, performance and feel of any knee implant will depend on various factors, including your physical condition, your activity level, adherence to your physician’s instructions, and other factors.

The Indications for Use of iTotal CR include:

  • Painful joint disease due to osteoarthritis, traumatic arthritis, rheumatoid arthritis or osteonecrosis of the knee.
  • Post traumatic loss of joint function.
  • Moderate varus, valgus or flexion deformity in which the ligamentous structures can be returned to adequate function and stability.
  • Failed osteotomies, hemiarthroplasties, and unicondylar, patellofemoral or bicompartmental implants.
  • Revision procedures provided that anatomic landmarks necessary for alignment and positioning of the implant are identifiable on patient imaging scans.

The implant is intended for cemented use only.

Caution: Federal law restricts this device to sale by or on the order of a physician.

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