The thing about efficiency is that docs love it or hate it. But, most like the patella spoons in the patella efficiency kit. Also, when you do the pricing for knees give them the same price with efficiency or without. Most hospitals are not going to pay more for them. Also, sure you are not bringing in a bunch of shit to CSR. But, you are bringing a lot of shit to the OR with efficiency and they won’t like that since the shit takes up a lot of space.