Robot-Assisted Total Knee Replacements: Better Results, Higher Costs – Study Reveals

2024-05-10 23:46:00

FRIDAY, May 10, 2024 (HealthDay News) — Robot-assisted total knee replacements tend to have better results on average, a new study reports.

Unfortunately, there is a downside: Having a surgical robot assist a human surgeon can make the procedure much more expensive.

Patients who underwent robot-assisted knee replacement stayed in the hospital for almost half a day less, and were significantly less likely to develop complications such as infections, excessive blood loss and fractures, dislocations or mechanical complications of their prosthesis, the researchers report.

But robotic knee replacements cost an average of $2,400 more than the conventional procedure, the researchers found.

The researchers said they hope the study will help doctors and patients make informed decisions regarding the best option for knee surgery.

“As the population continues to age, there will be greater demand for safe and effective total knee replacement surgery, also known as total knee arthroscopy (TKA),” lead researcher Dr. Senthil Sambandam, assistant professor of orthopedic surgery at UT Southwestern Medical Center in Dallas.

In knee replacement procedures, surgeons cut out bone damaged by arthritis and replace it with pieces of metal and plastic.

Surgeons perform most knee replacements by hand, judging how much bone to remove based on training and experience.

However, an increasing number of these procedures are performed with surgical robots that rely on image scans or anatomical landmarks to determine where to cut.

Using a robot theoretically improves accuracy and safety, but some studies have suggested that these improvements are minimal or non-existent.

To compare the two methods, the researchers compared the records of more than 540,000 people who had a traditional knee replacement with more than 17,000 who had a robot-assisted procedure. All operations were performed between 2016 and 2019.

In this analysis, the cost of robotic knee replacement was up to $15,000 higher than in previous comparative studies, the researchers noted.

The highest cost of the robotic procedure comes from the acquisition of the robotic equipment, which typically costs millions of dollars, as well as the disposable equipment needed for the surgery, the researchers said.

But robot-assisted knee replacement may be a more cost-effective option in hospitals that perform a large number of procedures, because fewer complications may offset the higher costs, Sambandam said.

The study found that robot-assisted knee replacement had:

88% lower risk of prosthesis dislocation.

68% lower risk of prosthetic mechanical complications.

64% lower risk of pulmonary embolism.

63% lower risk of excessive bleeding requiring transfusion.

53% lower risk of pneumonia.

52% lower risk of deep vein thrombosis.

27% lower risk of anemia due to blood loss.

The new study appears in the journal Archives of Orthopedic and Trauma Surgery.

More information

Johns Hopkins Medicine offers more information regarding knee replacement.

SOURCE: UT Southwestern Medical Center, news release, May 7, 2024

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