The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

Effects of Standardized Pricing for Distal Radius Implants

Document Type : RESEARCH PAPER

Authors
Samantha Riebesell 1
Michael Rivlin 1
Jeremiah A. Adams 1
Frederic L. Liss 1
Andrew J. Miller 2
Pedro K. Beredjiklian 1
1 Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA
2 Philadelphia Hand to Shoulder Center, Philadelphia, PA, USA
10.22038/abjs.2025.84630.3878
Abstract
Objectives: Critical evaluation of implant costs may help mitigate the cost of orthopedic care. In an effort to decrease the financial burden of operative fixation for fractures of the distal radius, a standardized shelf price was established by a large orthopedic practice for all distal radius implants. We hypothesized that by negotiating a fixed reduced cost, total number of screws, number of locking screws, and number of wasted screws would be unchanged and overall implant utilization would not change.
Methods: This was a retrospective analysis of the effect implant price standardization had on the operative care of distal radius fractures at a single outpatient urban surgical center. The total number of screws, as well as the number discarded during each procedure was reviewed. We analyzed the financials three months before and three months following price standardization. We surveyed the ten fellowship trained hand surgeons affected by the change regarding differences in operating procedure and perceived changes in the attendance and utility of the manufacturer’s representative.
Results: We reviewed 30 distal radius open reduction internal fixations three months before and 28 cases three months following shelf price implementation. On average, there was a 32% reduction in total implant costs after price standardization. No statistically significant difference in any clinical variables were noted. Negligible change was noted in the surgeon experience in representative availability and surgery-related attributes on the survey. 20% of surgeons switched implants due to the cost restrictions.
Conclusion: Despite a set price for distal radius implants, there was no significant difference in the number of screws utilized or discarded after price standardization. Additionally, despite a 32% reduction in cost, the level of representative attendance and utility were similar before and after the change. Surgeons are willing to be flexible in implant choices based on a cost restriction model.
        Level of evidence: III
Keywords
Distal radius
Fracture
Implant
Shelf pricing
Standardized pricing
Subjects
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The Archives of Bone and Joint Surgery
Volume 13, Issue 10
October 2025
Pages 638-642

  • Receive Date 02 January 2025
  • Revise Date 29 March 2025
  • Accept Date 13 April 2025