Robotic-assisted total knee replacements: Improved outcomes, higher costs

Editor's Note

A new study from UT Southwestern Medical Center shows that total knee replacements performed with the aid of surgical robots generally yield better outcomes compared to traditional manual procedures, but at a higher cost, UT Southwestern’s Newsroom May 7 reports. Published in the Archives of Orthopaedic and Trauma Surgery, this research offers insights into the benefits and costs of robotic-assisted surgeries and could significantly influence decision-making for patients and providers.

The study analyzed data from the National Inpatient Sample, which includes information from approximately 7 million hospital stays annually across the US. The researchers identified over half a million patients who underwent conventional total knee arthroplasty (TKA) and 17,249 patients who had robotic-assisted TKAs between 2016 and 2019.

Robotic TKAs use preoperative imaging or anatomical landmarks identified during surgery to enhance the precision of bone cuts, theoretically improving the accuracy and safety of the procedure. The study's findings highlighted that robotic TKAs resulted in shorter hospital stays by nearly half a day and significantly reduced the risk of various complications, including infections, excessive blood loss, and prosthetic-related issues like fractures, dislocations, or mechanical failures.

Despite these advantages, the cost of robotic TKAs was notably higher, averaging about $2,400 more than conventional procedures. This cost difference could be as high as $15,000. The study says the higher expenses are primarily because of the disposable equipment needed for robotic surgeries and the initial acquisition costs of the robotic systems, which can run into millions of dollars. The authors suggest that in high-volume facilities, where the frequency of surgical procedures may lead to more significant savings from reduced complications, robotic TKAs could prove more cost-effective despite the high upfront costs.