Systematic review and meta-analysis of economic and healthcare resource utilization outcomes for robotic versus manual total knee arthroplasty
The introduction of robotics in orthopedic surgery has led to improved precision and standardization in total knee arthroplasty (TKA). Clinical benefits of robotic versus manual TKA have been well established; however, evidence for economic and healthcare resource utilization outcomes (HRU) is lacki...
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| Veröffentlicht in: | Journal of robotic surgery 2023-12, Vol.17 (6), p.2899-2910 |
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| creator | Hoeffel, Daniel Goldstein, Laura Intwala, Dhara Kaindl, Lisa Dineen, Aidan Patel, Leena Mayle, Robert |
| description | The introduction of robotics in orthopedic surgery has led to improved precision and standardization in total knee arthroplasty (TKA). Clinical benefits of robotic versus manual TKA have been well established; however, evidence for economic and healthcare resource utilization outcomes (HRU) is lacking. The primary objective of this study was to compare economic and HRU outcomes for robotic and manual TKA. The secondary objective was to explore comparative robotic and manual TKA pain and opioid consumption outcomes. Multi-database literature searches were performed to identify studies comparing robotic and manual TKA from 2016 to 2022 and meta-analyses were conducted. This review included 50 studies with meta-analyses conducted on 35. Compared with manual TKA, robotic TKA was associated with a: 14% reduction in hospital length of stay (
P
= 0.022); 74% greater likelihood to be discharged to home (
P
|
| doi_str_mv | 10.1007/s11701-023-01703-x |
| format | Article |
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P
= 0.022); 74% greater likelihood to be discharged to home (
P
< 0.001); and 17% lower likelihood to experience a 90-day readmission (
P
= 0.043). Robotic TKA was associated with longer mean operating times (incision to closure definition: 9.27 min longer,
P
= 0.030; general operating time definition: 18.05 min longer,
P
= 0.006). No differences were observed for total procedure cost and 90-day emergency room visits. Most studies reported similar outcomes for robotic and manual TKA regarding pain and opioid use. Coupled with the clinical benefits of robotic TKA, the economic impact of using robotics may contribute to hospitals’ quality improvement and financial sustainability. Further research and more randomized controlled trials are needed to effectively quantify the benefits of robotic relative to manual TKA.</description><identifier>ISSN: 1863-2491</identifier><identifier>ISSN: 1863-2483</identifier><identifier>EISSN: 1863-2491</identifier><identifier>DOI: 10.1007/s11701-023-01703-x</identifier><language>eng</language><publisher>London: Springer London</publisher><subject>Arthritis ; Costs ; Economic analysis ; Economic impact ; Emergency medical services ; Emergency procedures ; Health care ; Hospitals ; Impact analysis ; Joint replacement surgery ; Knee ; Length of stay ; Literature reviews ; Medicine ; Medicine & Public Health ; Meta-analysis ; Minimally Invasive Surgery ; Orthopaedic implants ; Orthopedics ; Osteoarthritis ; Pain ; Patients ; Resource utilization ; Robotics ; Surgery ; Systematic review ; Urology</subject><ispartof>Journal of robotic surgery, 2023-12, Vol.17 (6), p.2899-2910</ispartof><rights>The Author(s) 2023</rights><rights>The Author(s) 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-f43db5f3ef4a5215d7a06f52a43101efff831ff68d187b8c5450beab078b9f413</citedby><cites>FETCH-LOGICAL-c396t-f43db5f3ef4a5215d7a06f52a43101efff831ff68d187b8c5450beab078b9f413</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11701-023-01703-x$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2918718137?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,21388,21389,27924,27925,33530,33531,33744,33745,41488,42557,43659,43805,51319,64385,64387,64389,72469</link.rule.ids></links><search><creatorcontrib>Hoeffel, Daniel</creatorcontrib><creatorcontrib>Goldstein, Laura</creatorcontrib><creatorcontrib>Intwala, Dhara</creatorcontrib><creatorcontrib>Kaindl, Lisa</creatorcontrib><creatorcontrib>Dineen, Aidan</creatorcontrib><creatorcontrib>Patel, Leena</creatorcontrib><creatorcontrib>Mayle, Robert</creatorcontrib><title>Systematic review and meta-analysis of economic and healthcare resource utilization outcomes for robotic versus manual total knee arthroplasty</title><title>Journal of robotic surgery</title><addtitle>J Robotic Surg</addtitle><description>The introduction of robotics in orthopedic surgery has led to improved precision and standardization in total knee arthroplasty (TKA). Clinical benefits of robotic versus manual TKA have been well established; however, evidence for economic and healthcare resource utilization outcomes (HRU) is lacking. The primary objective of this study was to compare economic and HRU outcomes for robotic and manual TKA. The secondary objective was to explore comparative robotic and manual TKA pain and opioid consumption outcomes. Multi-database literature searches were performed to identify studies comparing robotic and manual TKA from 2016 to 2022 and meta-analyses were conducted. This review included 50 studies with meta-analyses conducted on 35. Compared with manual TKA, robotic TKA was associated with a: 14% reduction in hospital length of stay (
P
= 0.022); 74% greater likelihood to be discharged to home (
P
< 0.001); and 17% lower likelihood to experience a 90-day readmission (
P
= 0.043). Robotic TKA was associated with longer mean operating times (incision to closure definition: 9.27 min longer,
P
= 0.030; general operating time definition: 18.05 min longer,
P
= 0.006). No differences were observed for total procedure cost and 90-day emergency room visits. Most studies reported similar outcomes for robotic and manual TKA regarding pain and opioid use. Coupled with the clinical benefits of robotic TKA, the economic impact of using robotics may contribute to hospitals’ quality improvement and financial sustainability. Further research and more randomized controlled trials are needed to effectively quantify the benefits of robotic relative to manual TKA.</description><subject>Arthritis</subject><subject>Costs</subject><subject>Economic analysis</subject><subject>Economic impact</subject><subject>Emergency medical services</subject><subject>Emergency procedures</subject><subject>Health care</subject><subject>Hospitals</subject><subject>Impact analysis</subject><subject>Joint replacement surgery</subject><subject>Knee</subject><subject>Length of stay</subject><subject>Literature reviews</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Minimally Invasive Surgery</subject><subject>Orthopaedic implants</subject><subject>Orthopedics</subject><subject>Osteoarthritis</subject><subject>Pain</subject><subject>Patients</subject><subject>Resource utilization</subject><subject>Robotics</subject><subject>Surgery</subject><subject>Systematic review</subject><subject>Urology</subject><issn>1863-2491</issn><issn>1863-2483</issn><issn>1863-2491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNp9kU1rGzEQhpfSQN2kfyAnQS-9bKJZ7Yd8DKb5gEAOac9iVh7F6-6uHI3WifMj8psrx4WGHnqRBvQ8L4zeLDsFeQZSNucM0EjIZaFymSaVP3_IZqBrlRflHD6-mz9ln5nXUlZNpWCWvd7vONKAsbMi0LajJ4HjUgwUMccR-x13LLwTZP3ohwTtX1eEfVxZDJQc9lOwJKbY9d1LyvGj8FO0fiAWzgcRfOv36VsKPLEYcJywF9HHdP4aiQSGuAp-0yPH3Ul25LBn-vLnPs5-Xn7_sbjOb--ubhYXt7lV8zrmrlTLtnKKXIlVAdWyQVm7qsBSgQRyzmkFztV6Cbppta3KSraErWx0O3clqOPs2yF3E_zjRBzN0LGlvseR_MSm0E1dq6TphH79B12njdPXJGqe4kGDahJVHCgbPHMgZzahGzDsDEizr8gcKjKpIvNWkXlOkjpInODxgcLf6P9YvwFuXpiR</recordid><startdate>20231201</startdate><enddate>20231201</enddate><creator>Hoeffel, Daniel</creator><creator>Goldstein, Laura</creator><creator>Intwala, Dhara</creator><creator>Kaindl, Lisa</creator><creator>Dineen, Aidan</creator><creator>Patel, Leena</creator><creator>Mayle, Robert</creator><general>Springer London</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FE</scope><scope>8FG</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>L6V</scope><scope>M0S</scope><scope>M7S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>7X8</scope></search><sort><creationdate>20231201</creationdate><title>Systematic review and meta-analysis of economic and healthcare resource utilization outcomes for robotic versus manual total knee arthroplasty</title><author>Hoeffel, Daniel ; Goldstein, Laura ; Intwala, Dhara ; Kaindl, Lisa ; Dineen, Aidan ; Patel, Leena ; Mayle, Robert</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c396t-f43db5f3ef4a5215d7a06f52a43101efff831ff68d187b8c5450beab078b9f413</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Arthritis</topic><topic>Costs</topic><topic>Economic analysis</topic><topic>Economic impact</topic><topic>Emergency medical services</topic><topic>Emergency procedures</topic><topic>Health care</topic><topic>Hospitals</topic><topic>Impact analysis</topic><topic>Joint replacement surgery</topic><topic>Knee</topic><topic>Length of stay</topic><topic>Literature reviews</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Minimally Invasive Surgery</topic><topic>Orthopaedic implants</topic><topic>Orthopedics</topic><topic>Osteoarthritis</topic><topic>Pain</topic><topic>Patients</topic><topic>Resource utilization</topic><topic>Robotics</topic><topic>Surgery</topic><topic>Systematic review</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hoeffel, Daniel</creatorcontrib><creatorcontrib>Goldstein, Laura</creatorcontrib><creatorcontrib>Intwala, Dhara</creatorcontrib><creatorcontrib>Kaindl, Lisa</creatorcontrib><creatorcontrib>Dineen, Aidan</creatorcontrib><creatorcontrib>Patel, Leena</creatorcontrib><creatorcontrib>Mayle, Robert</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Engineering Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Engineering Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Engineering Collection</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of robotic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hoeffel, Daniel</au><au>Goldstein, Laura</au><au>Intwala, Dhara</au><au>Kaindl, Lisa</au><au>Dineen, Aidan</au><au>Patel, Leena</au><au>Mayle, Robert</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Systematic review and meta-analysis of economic and healthcare resource utilization outcomes for robotic versus manual total knee arthroplasty</atitle><jtitle>Journal of robotic surgery</jtitle><stitle>J Robotic Surg</stitle><date>2023-12-01</date><risdate>2023</risdate><volume>17</volume><issue>6</issue><spage>2899</spage><epage>2910</epage><pages>2899-2910</pages><issn>1863-2491</issn><issn>1863-2483</issn><eissn>1863-2491</eissn><abstract>The introduction of robotics in orthopedic surgery has led to improved precision and standardization in total knee arthroplasty (TKA). Clinical benefits of robotic versus manual TKA have been well established; however, evidence for economic and healthcare resource utilization outcomes (HRU) is lacking. The primary objective of this study was to compare economic and HRU outcomes for robotic and manual TKA. The secondary objective was to explore comparative robotic and manual TKA pain and opioid consumption outcomes. Multi-database literature searches were performed to identify studies comparing robotic and manual TKA from 2016 to 2022 and meta-analyses were conducted. This review included 50 studies with meta-analyses conducted on 35. Compared with manual TKA, robotic TKA was associated with a: 14% reduction in hospital length of stay (
P
= 0.022); 74% greater likelihood to be discharged to home (
P
< 0.001); and 17% lower likelihood to experience a 90-day readmission (
P
= 0.043). Robotic TKA was associated with longer mean operating times (incision to closure definition: 9.27 min longer,
P
= 0.030; general operating time definition: 18.05 min longer,
P
= 0.006). No differences were observed for total procedure cost and 90-day emergency room visits. Most studies reported similar outcomes for robotic and manual TKA regarding pain and opioid use. Coupled with the clinical benefits of robotic TKA, the economic impact of using robotics may contribute to hospitals’ quality improvement and financial sustainability. Further research and more randomized controlled trials are needed to effectively quantify the benefits of robotic relative to manual TKA.</abstract><cop>London</cop><pub>Springer London</pub><doi>10.1007/s11701-023-01703-x</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| source | ProQuest Central (Alumni Edition); ProQuest Central UK/Ireland; SpringerLink Journals - AutoHoldings; ProQuest Central |
| subjects | Arthritis Costs Economic analysis Economic impact Emergency medical services Emergency procedures Health care Hospitals Impact analysis Joint replacement surgery Knee Length of stay Literature reviews Medicine Medicine & Public Health Meta-analysis Minimally Invasive Surgery Orthopaedic implants Orthopedics Osteoarthritis Pain Patients Resource utilization Robotics Surgery Systematic review Urology |
| title | Systematic review and meta-analysis of economic and healthcare resource utilization outcomes for robotic versus manual total knee arthroplasty |
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