to Dr. Berend. He says the up-front cost of custom implants and the
shaky promise of long-term cost savings is enough to steer him away.
But custom implants don't have to be prohibitively expensive, says
Raj Sinha, MD, PhD, an orthopedic surgeon at STAR Ortho in Rancho
Mirage, Calif. "It's whatever you negotiate," says Dr. Sinha. "There's no
hard and fast number there."
3. Cut out the clutter
Dr. Sinha discovered a massive cost hiding in his OR when he was
working at the University of Pittsburgh years ago. For every total
knee replacement, staff would open the routine basic set of surgical
instruments, which could number around 200 implements. But Dr.
Sinha only used 20 items for each surgery and wondered why so
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