A 90-Day Episode-of-Care Analysis Including Computed Tomography Scans of Robotic-Arm Assisted versus Manual Total Knee Arthroplasty

Abstract

In this observational, retrospective study, we performed economic analyses between robotic arm-assisted total knee arthroplasty (RATKA) and manual total knee arthroplasty (MTKA). Specifically, we compared: (1) index costs including computed tomography (CT) scans; (2) 90-day postoperative health care utilization, (3) 90-day episode-of-care (EOC) costs, and (4) lengths of stay between CT scan-based robotically-assisted versus MTKAs. A large national database, Blue Health Intelligence (BHI), was used for RATKAs and MTKAs performed between April 1, 2017 and September 30, 2019. Based on strict inclusion–exclusion criteria, with propensity score matching, 4,135 RATKAs and 4,135 MTKAs were identified and analyzed. Index costs to the payer for RATKA patients were found to be less than those for MTKA patients ($29,984 vs. $31,280, p <0.0001). Overall, 90-day EOC costs for RATKA patients were found to be less than that for MTKA patients in the inpatient and outpatient settings. This also holds true for the use of skilled nursing facilities, pharmacies, or other services. In conclusion, the results from our study show that RATKA were associated with lower costs than MTKAs, even when including the cost of CT scans. These results are of marked importance given the emphasis to contain and reduce health care costs.

Understanding economic analysis and cost–effectiveness of CT scan-guided, 3-dimensional, robotic-arm assisted lower extremity arthroplasty: a systematic review

“…This report demonstrated that advanced technologies are becoming more widely accepted and practiced. Therefore, knowledge about the economic utility of robotics is important as we enter a time where healthcare costs continue to grow, and our findings support the economic benefit of rTJA [ 35 , 44–46 ].…”

“…A 2022 article by Gregory et al [ 35 ] utilized a large national payer database (Blue Health Intelligence) to evaluate 90-day EOC costs and utilizations for rTKA and mTKA cases performed between 2017 and 2019. The cost of the CT scan was included in this study as part of index costs.…”

Advantages of robotic arm-assisted total hip arthroplasty: a 90-day episode-of-care clinical utility and cost analysis

“…Although there is limited cost-consideration-based data for RATHA, several studies have shown cost savings as well as patient outcome advantages when utilizing robotic arm assistance for total knee arthroplasty [ 7 , 8 ]. In one study by Gregory et al , the authors utilized a large national database comparing robotic-assisted (n = 4135) versus manual (n = 4135) total knee arthroplasties and found significant cost savings based on a 90-day episode of care (EOC) analysis ($29,984 vs $31,280, p < 0.0001) [ 9 ]. In another study, Cool et al , also found significant 90-day EOC cost savings for patients who underwent robotic-assisted versus manual total knee arthroplasty ($2391 less for robotic TKA [p < 0.0001]) [ 8 ].…”