**1. Introduction**

Total knee arthroplasty (TKA) is one of the most successful elective surgical procedures available [1], allowing for the treatment of end-stage osteoarthritis and functional limitation to restore patient mobility and functional activity. Recent reports project that elective joint replacement surgery will be the most common surgical procedure over the next 10 years [2, 3], and the number of TKAs performed in the United States (US) is estimated to increase exponentially—approximately 401% by 2040 compared to the 2014 US National Implant Services (NIS) database [4]. Meanwhile, according to the Centers for Medicare and Medicaid, healthcare expenditures are projected to grow at a rate of 5.8% per year [5] with a significant number of hospital costs being derived from operating room expenses [6]. Consequently, there is a push to maximize efficiency, including streamlining operating room flow (set up, surgical time, turnaround time) while reducing cost and risks of infection. This improved efficiency must come without sacrificing patient outcomes in an effort to rein in ballooning healthcare

costs. In this chapter, we will highlight the significance of a modern universal total knee arthroplasty system in helping to simplify the OR and save on healthcare expenditures.
