Computer-Assisted Technologies in Arthroplasty

Hazratwala, Kaushik; Brereton, Sarah G; Grant, Alan; Dlaska, Constantin Edmond

doi:10.2106/jbjs.rvw.19.00157

Cited by 14 publications

(15 citation statements)

References 72 publications

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“…Technology-assisted arthroplasty, which includes computerassisted navigation (CAN) and robotic assistance (RA), has been available since the 1990s for total knee arthroplasty (TKA) [1,2]. Adoption of technology assistance for TKA has varied globally; over one-third of all arthroplasties performed in Australia use CAN, while fewer than one percent of arthroplasties performed in Sweden are technology-assisted [1].…”

Section: Introductionmentioning

confidence: 99%

Trends of Utilization and 90-Day Complication Rates for Computer-Assisted Navigation and Robotic Assistance for Total Knee Arthroplasty in the United States From 2010 to 2018

et al. 2021

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Background: Computer-assisted navigation (CAN) and robotic assistance (RA) for total knee arthroplasty (TKA) are gaining in popularity. The purpose of this study is to update the literature on United States technology-assisted TKA trends of national utilization, regional utilization, and 90-day complication rates requiring readmission. Methods: Patients who underwent primary, elective TKA between 2010 and 2018 were retrospectively identified in the PearlDiver All Payer Claims Database (PearlDiver Technologies Inc.). TKAs were classified as conventional, CAN, or RA based on International Classification of Diseases nineth or tenth revision and Current Procedural Technology codes. Annual rates and regional trends of each type of TKA were reported. Ninety-day complications requiring readmission for each group were captured. Multivariable logistic regression was used to identify odds ratios (OR) for all-cause readmission based on TKA modality. Results: Of the 1,307,411 elective TKAs performed from 2010 to 2018, 92.8% were conventional, and 7.7% were technology-assisted (95.2% CAN and 4.9% RA). RA-TKA had the greatest increase in utilization (þ2204%). The Western region had the highest utilization of technologies for TKA, while the Midwestern region had the lowest. Ninety-day postoperative complications requiring readmission were highest for conventional TKA and lowest for RA-TKA. RA-TKA (OR 0.68; 97.5% confidence interval 0.56-0.83, P < .001) and CAN-TKA (OR 0.93; 97.5% confidence interval 0.88-0.97, P < .05) had significantly lower odds of allcause 90-day complications requiring readmission than conventional TKA. Conclusion: Utilization of RA-TKA and CAN-TKA continues to rise across the United States. The use of these technologies is associated with a lower OR of readmission within 90 days postoperatively.

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Section: Introductionmentioning

confidence: 99%

Trends of Utilization and 90-Day Complication Rates for Computer-Assisted Navigation and Robotic Assistance for Total Knee Arthroplasty in the United States From 2010 to 2018

et al. 2021

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“…However some disadvantages are cited related to the use of robot like longer surgical time; learning curve, costs; dubious results regarding to function and patient satisfaction; and surgery durability [15].…”

Section: Reviewmentioning

confidence: 99%

“…Other advantage could be the lesser amount of trays and instruments to perform the surgery, reducing logistics and sterilization costs [4,6,15].…”

Section: Reviewmentioning

confidence: 99%

Robotically Assisted Total Knee Arthroplasty - Literature Review

Vinicius¹,

Fernandes²

2022

J Musculoskelet Disord Treat

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Despite the evolution in implant design, surgical technique, rehabilitation and better medical training, a great number of patients are not satisfied with the final result of Total Knee Arthroplasty (TKA). The conventional TKA technique could result in a high number of outliers in limb alignment and are related to a high rate of residual symptoms. Robotically assisted (RA) surgery was introduced to improve these results. Recent studies showed this technique is associated to lower costs, better accuracy in implant placement and limb alignment, improvement in function and patient satisfaction. RA technique is also related to less blood loss, less bone resection and smaller aggression to soft tissues. Besides that, this brings better ergonomics to the surgeon with less caloric waste. In this way, by the benefits showed, the adhesion to the robotic surgery must be encouraged.

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“…With regards to cervical spinal procedures in particular, computer-aided navigation has been shown to improve visualization and instrumentation accuracy 4. However, the impact of computer-aided navigation on clinical outcomes is not well studied 2. No studies to our knowledge have examined the impact of computer-aided navigation on patient outcomes following cervical spinal procedures.…”

mentioning

confidence: 99%

The Impact of Computer-Assisted Navigation on Charges and Readmission in Patients Undergoing Posterior Cervical Fusion Surgery

Tang

Dominy

Arvind

et al. 2022

Clinical Spine Surgery: A Spine Publication

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Objective: The aim was to evaluate cost and outcomes associated with navigation use on posterior cervical fusion (PCF) surgery patients.Summary of Background Data: Computer-assisted navigation systems demonstrate comparable outcomes with hardware placement and procedural speed compared with traditional techniques. Innovations in technology continue to improve surgeons' performance in complicated procedures, causing need to analyze the impact on patient care. Methods:The 2016 NRD was queried for patients with PCF surgery ICD-10 codes. Cost and readmission rates were compared with and without navigation. Nonelective cases and patients below 18 years of age were excluded. Univariate analysis on demographics, surgical data, and total charges was performed. Lastly, multivariate analysis was performed to assess navigation's impact on cost and postoperative outcomes.Results: A total of 11,834 patients were identified, with 137 (1.2%) patients undergoing surgery with navigation and 11,697 (98.8%) patients without. Average total charge was $131,939.47 and $141,270.1 for the non-navigation and navigation cohorts, respectively (P = 0.349). Thirty-day and 90-day readmission rates were not significantly lower in patients who received navigation versus those that did not (P = 0.087). This remained insignificant after adjusting for several variables, age above 65, sex, medicare status, mental health history, and comorbidities. The model adjusting for demographic and comorbidities maintained insignificant results of navigation being associated with decreased 30-day and 90-day readmissions (P = 0.079).Conclusions: Navigation use in PCF surgery was not associated with increased cost, and patients operated on with navigation did not significantly have increased routine discharge or decreased 90-day readmission. As a result, future studies must continue to evaluate the cost-benefit of navigation use for cervical fusion surgery.

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Computer-Assisted Technologies in Arthroplasty

Cited by 14 publications

References 72 publications

Trends of Utilization and 90-Day Complication Rates for Computer-Assisted Navigation and Robotic Assistance for Total Knee Arthroplasty in the United States From 2010 to 2018

Trends of Utilization and 90-Day Complication Rates for Computer-Assisted Navigation and Robotic Assistance for Total Knee Arthroplasty in the United States From 2010 to 2018

Robotically Assisted Total Knee Arthroplasty - Literature Review

The Impact of Computer-Assisted Navigation on Charges and Readmission in Patients Undergoing Posterior Cervical Fusion Surgery

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