A Cost Analysis of Traditional Versus Robotic Total Knee Arthroplasty Performed With an Imageless, Second-generation Robotic System.

IF 1.1 4区 医学 Q3 ORTHOPEDICS Orthopedics Pub Date : 2024-08-19 DOI:10.3928/01477447-20240809-05
Justin Leal, Niall H Cochrane, Billy I Kim, Christopher T Holland, Rhett Hallows, Thorsten Seyler
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Abstract

Background: This study compared perioperative outcomes as well as encounter and 90-day costs between patients undergoing traditional vs robotic total knee arthroplasty (rTKA).

Materials and methods: A total of 430 TKAs (215 rTKAs, 215 traditional) were retrospectively reviewed. All rTKAs were performed with an imageless, second-generation robotic system. Cohorts were propensity score matched by age, sex, body mass index, and American Society of Anesthesiologists score. Perioperative data and 90-day complications were subsequently compared. Cox regression analyses evaluated survival to all-cause revisions. Univariable analyses compared total cost of care for the initial encounter and 90-day postoperative period. Multivariable regression analyses were then performed to evaluate associations with increased encounter and 90-day costs.

Results: Patients undergoing rTKA had a higher incidence of discharge home (86.5% vs 60.0%; P<.001). The rTKA cohort trended toward a lower incidence of 90-day emergency department visits, and there was a significantly lower percentage of 90-day readmissions (4.2% vs 13.5%; P=.001). Cox hazard ratio demonstrated no difference in survival to all-cause revisions (hazard ratio, 1.3; 95% CI, 0.5-3.7; P=.64). The cost of surgery was significantly higher in the rTKA cohort ($9292 vs $8392; P<.001); however, there was no difference in cost of encounter ($10,356.86 vs $10,396.44; P=.110) or at 90 days postoperatively ($11,103.89 vs $11,040.13; P=.739). rTKA did not have a significant association with increased cost at 90 days postoperatively (odds ratio, 0.96; 95% CI, 0.90-1.02; P=.180).

Conclusion: rTKA had a higher intraoperative cost compared with traditional TKA. However, with increased home discharges and fewer 90-day readmissions, rTKA was not associated with increased cost at 90 days. [Orthopedics. 202x;4x(x):xx-xx.].

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使用无图像第二代机器人系统进行传统与机器人全膝关节置换术的成本分析。
背景:本研究比较了接受传统与机器人全膝关节置换术(rTKA)的患者的围手术期结果以及就诊和 90 天费用:本研究比较了接受传统与机器人全膝关节置换术(rTKA)患者的围手术期结果以及就诊和90天费用:该研究回顾性分析了 430 例全膝关节置换术(215 例机器人全膝关节置换术,215 例传统全膝关节置换术)。所有rTKAs均使用无图像第二代机器人系统进行。按照年龄、性别、体重指数和美国麻醉医师协会评分进行倾向评分匹配。随后对围手术期数据和 90 天并发症进行了比较。Cox 回归分析评估了全因改期的存活率。单变量分析比较了初次就诊和术后 90 天的总护理成本。然后进行多变量回归分析,以评估首次就诊和术后90天费用增加的相关性:结果:接受 rTKA 的患者出院回家的比例更高(86.5% vs 60.0%;PP=.001)。Cox危险比显示,全因复发的生存率没有差异(危险比,1.3;95% CI,0.5-3.7;P=.64)。rTKA队列的手术费用明显更高(9292美元 vs 8392美元;PP=.110),术后90天的费用也更高(11103.89美元 vs 11040.13美元;P=.739)。rTKA与术后90天的费用增加无明显关联(几率比0.96;95% CI,0.90-1.02;P=.180)。结论:与传统 TKA 相比,rTKA 的术中费用更高,但随着出院回家次数的增加和 90 天再入院次数的减少,rTKA 与 90 天费用的增加无关。[骨科。202x;4x(x):xx-xx]。
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来源期刊
Orthopedics
Orthopedics 医学-整形外科
CiteScore
2.20
自引率
0.00%
发文量
160
审稿时长
3 months
期刊介绍: For over 40 years, Orthopedics, a bimonthly peer-reviewed journal, has been the preferred choice of orthopedic surgeons for clinically relevant information on all aspects of adult and pediatric orthopedic surgery and treatment. Edited by Robert D''Ambrosia, MD, Chairman of the Department of Orthopedics at the University of Colorado, Denver, and former President of the American Academy of Orthopaedic Surgeons, as well as an Editorial Board of over 100 international orthopedists, Orthopedics is the source to turn to for guidance in your practice. The journal offers access to current articles, as well as several years of archived content. Highlights also include Blue Ribbon articles published full text in print and online, as well as Tips & Techniques posted with every issue.
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