Evaluating the cost of robotic-assisted total and unicompartmental knee arthroplasty
As uptake of robotic-assisted arthroplasty increases there is a need for economic evaluation of the implementation and ongoing costs associated with robotic surgery. The aims of this study were to describe the in-hospital cost of robotic-assisted total knee arthroplasty (RA-TKA) and robotic-assisted...
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| Veröffentlicht in: | Journal of robotic surgery 2024-05, Vol.18 (1), p.206, Article 206 |
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| creator | Alexander, Kate Karunaratne, Sascha Sidhu, Verinder Fritsch, Brett Gupta, Sanjeev Horsley, Mark Guzman, Maurice Boyle, Richard McBride, Kate Steffens, Daniel |
| description | As uptake of robotic-assisted arthroplasty increases there is a need for economic evaluation of the implementation and ongoing costs associated with robotic surgery. The aims of this study were to describe the in-hospital cost of robotic-assisted total knee arthroplasty (RA-TKA) and robotic-assisted unicompartmental knee arthroplasty (RA-UKA) and determine the influence of patient characteristics and surgical outcomes on cost. This prospective cohort study included adult patients (≥ 18 years) undergoing primary unilateral RA-TKA and RA-UKA, at a tertiary hospital in Sydney between April 2017 and June 2021. Patient characteristics, surgical outcomes, and in-hospital cost variables were extracted from hospital medical records. Differences between outcomes for RA-TKA and RA-UKA were compared using independent sample t-tests. Logistic regression was performed to determine drivers of cost. Of the 308 robotic-assisted procedures, 247 were RA-TKA and 61 were RA-UKA. Surgical time, time in the operating room, and length of stay were significantly shorter in RA-UKA (
p
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| doi_str_mv | 10.1007/s11701-024-01932-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3052595059</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3052595059</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-394ef04525c9a62d0fc162f813e06e69f1a0f221bebccaabf75a7cd713a0e4ae3</originalsourceid><addsrcrecordid>eNp9kDFv1jAQhi0EoqXlDzCgSCxdAnd2HCcjqkqLVImlna2Lc25TkvjDdpD673H7tYAYGKyzz8-9th4h3iF8RADzKSEawBpkUwP2StbdC3GIXatq2fT48q_9gXiT0h2ANlrha3GgOoPGgD4UV2c_ad4oT-tNlW-5ciHlKvgqhiHkydWU0pQyj1UOmeaK1rHa1smFZUcxL7w-NL-vzFU53sawmynl-2PxytOc-O1TPRLXX86uTi_qy2_nX08_X9ZOyTbXqm_YQ6Oldj21cgTvsJW-Q8XQctt7JPBS4sCDc0SDN5qMGw0qAm6I1ZE42efuYvixccp2mZLjeaaVw5asgpLda9B9QT_8g96FLa7ld49UWb3GQsk95WJIKbK3uzgtFO8tgn1wbvfObXFuH53brgy9f4rehoXH3yPPkgug9kAqV-sNxz9v_yf2F5tnjWM</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3052305951</pqid></control><display><type>article</type><title>Evaluating the cost of robotic-assisted total and unicompartmental knee arthroplasty</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Alexander, Kate ; Karunaratne, Sascha ; Sidhu, Verinder ; Fritsch, Brett ; Gupta, Sanjeev ; Horsley, Mark ; Guzman, Maurice ; Boyle, Richard ; McBride, Kate ; Steffens, Daniel</creator><creatorcontrib>Alexander, Kate ; Karunaratne, Sascha ; Sidhu, Verinder ; Fritsch, Brett ; Gupta, Sanjeev ; Horsley, Mark ; Guzman, Maurice ; Boyle, Richard ; McBride, Kate ; Steffens, Daniel</creatorcontrib><description>As uptake of robotic-assisted arthroplasty increases there is a need for economic evaluation of the implementation and ongoing costs associated with robotic surgery. The aims of this study were to describe the in-hospital cost of robotic-assisted total knee arthroplasty (RA-TKA) and robotic-assisted unicompartmental knee arthroplasty (RA-UKA) and determine the influence of patient characteristics and surgical outcomes on cost. This prospective cohort study included adult patients (≥ 18 years) undergoing primary unilateral RA-TKA and RA-UKA, at a tertiary hospital in Sydney between April 2017 and June 2021. Patient characteristics, surgical outcomes, and in-hospital cost variables were extracted from hospital medical records. Differences between outcomes for RA-TKA and RA-UKA were compared using independent sample t-tests. Logistic regression was performed to determine drivers of cost. Of the 308 robotic-assisted procedures, 247 were RA-TKA and 61 were RA-UKA. Surgical time, time in the operating room, and length of stay were significantly shorter in RA-UKA (
p
< 0.001); whereas RA-TKA patients were older (
p
= 0.002) and more likely to be discharged to in-patient rehabilitation (
p
= 0.009). Total in-hospital cost was significantly higher for RA-TKA cases (AU$18580.02 vs $13275.38;
p
< 0.001). Robotic system and maintenance cost per case was AU$3867.00 for TKA and AU$5008.77 for UKA. Patients born overseas and lower volume robotic surgeons were significantly associated with higher total cost of RA-UKA. Increasing age and male gender were significantly associated with higher total cost of RA-TKA. Total cost was significantly higher for RA-TKA than RA-UKA. Robotic system costs for RA-UKA are inflated by the software cost relative to the volume of cases compared with RA-TKA. Cost is an important consideration when evaluating long term benefits of robotic-assisted knee arthroplasty in future studies to provide evidence for the economic sustainability of this practice.</description><identifier>ISSN: 1863-2491</identifier><identifier>ISSN: 1863-2483</identifier><identifier>EISSN: 1863-2491</identifier><identifier>DOI: 10.1007/s11701-024-01932-8</identifier><identifier>PMID: 38717705</identifier><language>eng</language><publisher>London: Springer London</publisher><subject>Aged ; Arthritis ; Arthroplasty, Replacement, Knee - economics ; Arthroplasty, Replacement, Knee - methods ; Body mass index ; Country of birth ; Female ; Health insurance ; Hospital costs ; Hospital Costs - statistics & numerical data ; Hospitals ; Humans ; Joint replacement surgery ; Knee ; Length of stay ; Length of Stay - economics ; Length of Stay - statistics & numerical data ; Maintenance costs ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Minimally Invasive Surgery ; Operative Time ; Osteoarthritis ; Patients ; Prospective Studies ; Regression analysis ; Rehabilitation ; Robotic surgery ; Robotic Surgical Procedures - economics ; Robotic Surgical Procedures - methods ; Software ; Surgeons ; Surgery ; Surgical outcomes ; Treatment Outcome ; Urology</subject><ispartof>Journal of robotic surgery, 2024-05, Vol.18 (1), p.206, Article 206</ispartof><rights>Crown 2024</rights><rights>2024. Crown.</rights><rights>Copyright Springer Nature B.V. Dec 2024</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-394ef04525c9a62d0fc162f813e06e69f1a0f221bebccaabf75a7cd713a0e4ae3</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/s11701-024-01932-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11701-024-01932-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38717705$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Alexander, Kate</creatorcontrib><creatorcontrib>Karunaratne, Sascha</creatorcontrib><creatorcontrib>Sidhu, Verinder</creatorcontrib><creatorcontrib>Fritsch, Brett</creatorcontrib><creatorcontrib>Gupta, Sanjeev</creatorcontrib><creatorcontrib>Horsley, Mark</creatorcontrib><creatorcontrib>Guzman, Maurice</creatorcontrib><creatorcontrib>Boyle, Richard</creatorcontrib><creatorcontrib>McBride, Kate</creatorcontrib><creatorcontrib>Steffens, Daniel</creatorcontrib><title>Evaluating the cost of robotic-assisted total and unicompartmental knee arthroplasty</title><title>Journal of robotic surgery</title><addtitle>J Robotic Surg</addtitle><addtitle>J Robot Surg</addtitle><description>As uptake of robotic-assisted arthroplasty increases there is a need for economic evaluation of the implementation and ongoing costs associated with robotic surgery. The aims of this study were to describe the in-hospital cost of robotic-assisted total knee arthroplasty (RA-TKA) and robotic-assisted unicompartmental knee arthroplasty (RA-UKA) and determine the influence of patient characteristics and surgical outcomes on cost. This prospective cohort study included adult patients (≥ 18 years) undergoing primary unilateral RA-TKA and RA-UKA, at a tertiary hospital in Sydney between April 2017 and June 2021. Patient characteristics, surgical outcomes, and in-hospital cost variables were extracted from hospital medical records. Differences between outcomes for RA-TKA and RA-UKA were compared using independent sample t-tests. Logistic regression was performed to determine drivers of cost. Of the 308 robotic-assisted procedures, 247 were RA-TKA and 61 were RA-UKA. Surgical time, time in the operating room, and length of stay were significantly shorter in RA-UKA (
p
< 0.001); whereas RA-TKA patients were older (
p
= 0.002) and more likely to be discharged to in-patient rehabilitation (
p
= 0.009). Total in-hospital cost was significantly higher for RA-TKA cases (AU$18580.02 vs $13275.38;
p
< 0.001). Robotic system and maintenance cost per case was AU$3867.00 for TKA and AU$5008.77 for UKA. Patients born overseas and lower volume robotic surgeons were significantly associated with higher total cost of RA-UKA. Increasing age and male gender were significantly associated with higher total cost of RA-TKA. Total cost was significantly higher for RA-TKA than RA-UKA. Robotic system costs for RA-UKA are inflated by the software cost relative to the volume of cases compared with RA-TKA. Cost is an important consideration when evaluating long term benefits of robotic-assisted knee arthroplasty in future studies to provide evidence for the economic sustainability of this practice.</description><subject>Aged</subject><subject>Arthritis</subject><subject>Arthroplasty, Replacement, Knee - economics</subject><subject>Arthroplasty, Replacement, Knee - methods</subject><subject>Body mass index</subject><subject>Country of birth</subject><subject>Female</subject><subject>Health insurance</subject><subject>Hospital costs</subject><subject>Hospital Costs - statistics & numerical data</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Joint replacement surgery</subject><subject>Knee</subject><subject>Length of stay</subject><subject>Length of Stay - economics</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Maintenance costs</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Minimally Invasive Surgery</subject><subject>Operative Time</subject><subject>Osteoarthritis</subject><subject>Patients</subject><subject>Prospective Studies</subject><subject>Regression analysis</subject><subject>Rehabilitation</subject><subject>Robotic surgery</subject><subject>Robotic Surgical Procedures - economics</subject><subject>Robotic Surgical Procedures - methods</subject><subject>Software</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Treatment Outcome</subject><subject>Urology</subject><issn>1863-2491</issn><issn>1863-2483</issn><issn>1863-2491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kDFv1jAQhi0EoqXlDzCgSCxdAnd2HCcjqkqLVImlna2Lc25TkvjDdpD673H7tYAYGKyzz8-9th4h3iF8RADzKSEawBpkUwP2StbdC3GIXatq2fT48q_9gXiT0h2ANlrha3GgOoPGgD4UV2c_ad4oT-tNlW-5ciHlKvgqhiHkydWU0pQyj1UOmeaK1rHa1smFZUcxL7w-NL-vzFU53sawmynl-2PxytOc-O1TPRLXX86uTi_qy2_nX08_X9ZOyTbXqm_YQ6Oldj21cgTvsJW-Q8XQctt7JPBS4sCDc0SDN5qMGw0qAm6I1ZE42efuYvixccp2mZLjeaaVw5asgpLda9B9QT_8g96FLa7ld49UWb3GQsk95WJIKbK3uzgtFO8tgn1wbvfObXFuH53brgy9f4rehoXH3yPPkgug9kAqV-sNxz9v_yf2F5tnjWM</recordid><startdate>20240508</startdate><enddate>20240508</enddate><creator>Alexander, Kate</creator><creator>Karunaratne, Sascha</creator><creator>Sidhu, Verinder</creator><creator>Fritsch, Brett</creator><creator>Gupta, Sanjeev</creator><creator>Horsley, Mark</creator><creator>Guzman, Maurice</creator><creator>Boyle, Richard</creator><creator>McBride, Kate</creator><creator>Steffens, Daniel</creator><general>Springer London</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20240508</creationdate><title>Evaluating the cost of robotic-assisted total and unicompartmental knee arthroplasty</title><author>Alexander, Kate ; Karunaratne, Sascha ; Sidhu, Verinder ; Fritsch, Brett ; Gupta, Sanjeev ; Horsley, Mark ; Guzman, Maurice ; Boyle, Richard ; McBride, Kate ; Steffens, Daniel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-394ef04525c9a62d0fc162f813e06e69f1a0f221bebccaabf75a7cd713a0e4ae3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Arthritis</topic><topic>Arthroplasty, Replacement, Knee - economics</topic><topic>Arthroplasty, Replacement, Knee - methods</topic><topic>Body mass index</topic><topic>Country of birth</topic><topic>Female</topic><topic>Health insurance</topic><topic>Hospital costs</topic><topic>Hospital Costs - statistics & numerical data</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Joint replacement surgery</topic><topic>Knee</topic><topic>Length of stay</topic><topic>Length of Stay - economics</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Maintenance costs</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Minimally Invasive Surgery</topic><topic>Operative Time</topic><topic>Osteoarthritis</topic><topic>Patients</topic><topic>Prospective Studies</topic><topic>Regression analysis</topic><topic>Rehabilitation</topic><topic>Robotic surgery</topic><topic>Robotic Surgical Procedures - economics</topic><topic>Robotic Surgical Procedures - methods</topic><topic>Software</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Treatment Outcome</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Alexander, Kate</creatorcontrib><creatorcontrib>Karunaratne, Sascha</creatorcontrib><creatorcontrib>Sidhu, Verinder</creatorcontrib><creatorcontrib>Fritsch, Brett</creatorcontrib><creatorcontrib>Gupta, Sanjeev</creatorcontrib><creatorcontrib>Horsley, Mark</creatorcontrib><creatorcontrib>Guzman, Maurice</creatorcontrib><creatorcontrib>Boyle, Richard</creatorcontrib><creatorcontrib>McBride, Kate</creatorcontrib><creatorcontrib>Steffens, Daniel</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of robotic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Alexander, Kate</au><au>Karunaratne, Sascha</au><au>Sidhu, Verinder</au><au>Fritsch, Brett</au><au>Gupta, Sanjeev</au><au>Horsley, Mark</au><au>Guzman, Maurice</au><au>Boyle, Richard</au><au>McBride, Kate</au><au>Steffens, Daniel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluating the cost of robotic-assisted total and unicompartmental knee arthroplasty</atitle><jtitle>Journal of robotic surgery</jtitle><stitle>J Robotic Surg</stitle><addtitle>J Robot Surg</addtitle><date>2024-05-08</date><risdate>2024</risdate><volume>18</volume><issue>1</issue><spage>206</spage><pages>206-</pages><artnum>206</artnum><issn>1863-2491</issn><issn>1863-2483</issn><eissn>1863-2491</eissn><abstract>As uptake of robotic-assisted arthroplasty increases there is a need for economic evaluation of the implementation and ongoing costs associated with robotic surgery. The aims of this study were to describe the in-hospital cost of robotic-assisted total knee arthroplasty (RA-TKA) and robotic-assisted unicompartmental knee arthroplasty (RA-UKA) and determine the influence of patient characteristics and surgical outcomes on cost. This prospective cohort study included adult patients (≥ 18 years) undergoing primary unilateral RA-TKA and RA-UKA, at a tertiary hospital in Sydney between April 2017 and June 2021. Patient characteristics, surgical outcomes, and in-hospital cost variables were extracted from hospital medical records. Differences between outcomes for RA-TKA and RA-UKA were compared using independent sample t-tests. Logistic regression was performed to determine drivers of cost. Of the 308 robotic-assisted procedures, 247 were RA-TKA and 61 were RA-UKA. Surgical time, time in the operating room, and length of stay were significantly shorter in RA-UKA (
p
< 0.001); whereas RA-TKA patients were older (
p
= 0.002) and more likely to be discharged to in-patient rehabilitation (
p
= 0.009). Total in-hospital cost was significantly higher for RA-TKA cases (AU$18580.02 vs $13275.38;
p
< 0.001). Robotic system and maintenance cost per case was AU$3867.00 for TKA and AU$5008.77 for UKA. Patients born overseas and lower volume robotic surgeons were significantly associated with higher total cost of RA-UKA. Increasing age and male gender were significantly associated with higher total cost of RA-TKA. Total cost was significantly higher for RA-TKA than RA-UKA. Robotic system costs for RA-UKA are inflated by the software cost relative to the volume of cases compared with RA-TKA. Cost is an important consideration when evaluating long term benefits of robotic-assisted knee arthroplasty in future studies to provide evidence for the economic sustainability of this practice.</abstract><cop>London</cop><pub>Springer London</pub><pmid>38717705</pmid><doi>10.1007/s11701-024-01932-8</doi></addata></record> |
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| ispartof | Journal of robotic surgery, 2024-05, Vol.18 (1), p.206, Article 206 |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Aged Arthritis Arthroplasty, Replacement, Knee - economics Arthroplasty, Replacement, Knee - methods Body mass index Country of birth Female Health insurance Hospital costs Hospital Costs - statistics & numerical data Hospitals Humans Joint replacement surgery Knee Length of stay Length of Stay - economics Length of Stay - statistics & numerical data Maintenance costs Male Medicine Medicine & Public Health Middle Aged Minimally Invasive Surgery Operative Time Osteoarthritis Patients Prospective Studies Regression analysis Rehabilitation Robotic surgery Robotic Surgical Procedures - economics Robotic Surgical Procedures - methods Software Surgeons Surgery Surgical outcomes Treatment Outcome Urology |
| title | Evaluating the cost of robotic-assisted total and unicompartmental knee arthroplasty |
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