OTA 2006 Posters


Scientific Poster #36 Foot and Ankle

The Economic Impact of Reprocessing External Fixation Components
Dan Horwitz, MD (e-Stryker);
Kathryn Schabel, MD (*);
Thomas Higgins, MD (e-Stryker);
University of Utah, Salt Lake City, Utah, USA


Introduction: The ongoing trend toward temporizing external fixation has led to great expenditure on implants that are only used briefly. This movement, combined with the increasing pressure to reduce health care expenditures, has driven the exploration of reuse of medical implants that were previously only single-use devices. This necessitates the testing and recertification of these devices prior to redeployment in hospital stock.

Purpose: Our study defines the rate of manufacturer recertification and institutional cost savings associated with this program.

Methods/Materials: All Hoffman II external fixation components (Stryker Howmedica Osteonics) removed at our institution during the study period were submitted to the manufacturer for visual inspection and mechanical testing. Pass rates for original components and previously recycled components were determined. Using a more conservative pass rate, and assuming a maximum of three total deployments of each component, total potential hospital savings on external fixation are calculated.

Results: First pass rate was 83%. Second pass rate was 83%, but based on a limited sample. Using a conservative estimate of pass rate of 75%, the predicted average number of uses of a recyclable component was 2.7. However, only 85% of the new external fixation component charges are spent on portions of the system that are recyclable (carbon fiber bars and half-pins are not recycled). The recycled and recertified gear was sold back to our hospital at 50% of original price. Therefore, the total savings over the course of 1 year equals 32% of total external fixation expenditures. At our Level 1 trauma center, this projection equaled $49,140 based on 2003 expenditures, or $47,050 based on 2004 expenditures. There were no failures of recertified components over the course of this study.

Conclusion: In an era of growing medical fiscal austerity, recycling appears inevitable. Our paper demonstrates the real cost savings associated with a manufacturer-based testing and recertification program. The manufacturer testing and recertification of external fixation components can offer institutions potential savings of 32% of their total external fixation invoice without impacting patient safety.


If noted, the author indicates something of value received. The codes are identified as a-research or institutional support; b-miscellaneous funding; c-royalties; d-stock options; e-consultant or employee; n-no conflicts disclosed, and *disclosure not available at time of printing.
· The FDA has not cleared this drug and/or medical device for the use described in this presentation (i.e., the drug or medical device is being discussed for an "off label" use). · · FDA information not available at time of printing.