A study finds that using robotic equipment in total knee replacement surgeries often costs more but may result in better outcomes for some patients.
Researchers also suggest that robotic total knee arthroscopy (TKA) may be a more cost-effective option in high-volume hospitals, where savings from reduced complications can help offset the higher costs.
Researchers at UT Southwestern Medical Centre, who published their findings in the Archives of Orthopaedic and Trauma Surgery, could help surgeons tailor treatment for patients suffering knee degeneration and pain or disability.
Study leader Senthil Sambandam, assistant professor of orthopaedic surgery at UT Southwestern, said: ‘As the population ages, there will be a greater demand for safe and effective total knee arthroscopy (TKA). This study advances the field by outlining the differences between these two procedures.’
Most TKAs are performed by experienced surgeons who judge how much bone to remove. Many use surgical robots that rely on preoperative imaging or finding anatomical landmarks during surgery to determine where to cut, theoretically improving accuracy and safety.
However, some research suggests the margins are minimal and fail to justify the extra cost.
Dr Sambandam and his team analysed data from the National Inpatient Sample, a publicly accessible database that records approximately seven million hospital stays annually across the US.
Using diagnostic codes, the researchers identified 541,122 patients who underwent conventional total knee arthroplasties (TKAs) and 17,249 who had robotic TKAs between 2016 and 2019.
The team collected data on various aspects of these procedures, including the length of hospital stays, complications, costs, and patient demographic information.
The comparison revealed that patients who underwent robotic TKA had shorter hospital stays that were nearly half a day and experienced significantly fewer complications, such as infections, excessive blood loss, fractures, dislocations, or mechanical issues with their prosthetics.
However, on average, the robotic TKA procedures were about $2,400 more expensive than the conventional ones.
These findings were consistent even when adjusted for age, sex, race, tobacco use, diabetes and obesity. In some instances, the cost of robotic TKA was as much as $15,000 higher.
The researchers attributed the increased cost of robotic TKA to the higher expenses of disposable equipment required for the procedure and the acquisition of robotic equipment, which typically costs millions of dollars.
The results from this study can help doctors and patients discuss the pros and cons of both procedures and decide which option is best for each patient.
Other UTSW researchers who contributed to this study are the first author, medical student Vikram A Aggarwal, and orthopaedic surgery resident Joshua Sun.
