The Impact of Author Financial Conflicts on Robotic-Assisted Joint Arthroplasty Research

DeFrance, Michael; Yayac, Michael; Courtney, P. Maxwell; Squire, Matthew W.

doi:10.1016/j.arth.2020.10.033

Cited by 30 publications

(27 citation statements)

References 47 publications

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“…As there continues to be mixed evidence across the literature regarding how radiographic measurements impact functional outcomes and complication rates, we are unable to comment on which THA technique should be considered clinically superior across these domains. Furthermore, as the influence of conflict of interests on the RA‐THA literature remains controversial, it remains unclear whether industry influenced the findings of studies to any magnitude 55 . Despite these limitations, we believe we adequately reported on the current literature comparing the radiographic outcomes between RA‐THA and mTHA.…”

Section: Discussionmentioning

confidence: 97%

“…Furthermore, as the influence of conflict of interests on the RA-THA literature remains controversial, it remains unclear whether industry influenced the findings of studies to any magnitude. 55 Despite these limitations, we believe we adequately reported on the current literature comparing the radiographic outcomes between RA-THA and mTHA.…”

Section: Nakamura Et Al (2018) 26mentioning

confidence: 96%

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Robotic‐arm assisted versus manual total hip arthroplasty: Systematic review and meta‐analysis of radiographic accuracy

Samuel

Acuña

Kuo

et al. 2021

Robotics Computer Surgery

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Background:We systematically reviewed the radiological outcomes of studies comparing robotic-assisted (RA-THA) and manual total hip arthroplasty (mTHA). Methods:The PubMed, Embase, and Cochrane databases were queried from 1994-2021 for articles comparing radiographic outcomes between RA-THA and mTHA cohorts. A meta-analysis was conducted whenever sufficient data was present for common outcomes.Results: Our analysis included 20 articles reporting on 4140 patients (RA-THA: n = 1228; mTHA: n = 2912). No differences were demonstrated for acetabular inclination or anteversion. However, RA-THA demonstrated higher rates of cup orientation within the Lewinnek and Callanan safe zones, improved femoral stem alignment, and lower global offset difference (GOD) and limb length discrepancy (all p-values <0.05). Superior femoral canal fill and combined offset were seen among RA-THA patients. Conclusion:Our review found that the use of RA-THA yields superior radiographic outcomes compared to mTHA counterparts. This information can inform healthcare systems considering investing in and implementing these technologies.

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Section: Discussionmentioning

confidence: 97%

Section: Nakamura Et Al (2018) 26mentioning

confidence: 96%

Robotic‐arm assisted versus manual total hip arthroplasty: Systematic review and meta‐analysis of radiographic accuracy

Samuel

Acuña

Kuo

et al. 2021

Robotics Computer Surgery

View full text Add to dashboard Cite

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“…Nonusers also indicated that they were equally likely to consider marketing as increased precision in deciding whether to adopt RTKA [36]. Finally, a recent literature review reported that 97% of studies supporting robotic joint arthroplasty have been published by authors receiving financial compensation from industry [34]. Clearly, high quality, unbiased studies are needed to evaluate RTKA.…”

Section: Discussionmentioning

confidence: 99%

Robotic Versus Manual Total Knee Arthroplasty in High Volume Surgeons: A Comparison of Cost and Quality Metrics

Tompkins¹,

Sypher

et al. 2022

The Journal of Arthroplasty

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“…In addition, DeFrance et al. reported that nearly all studies (91%) comparing robotic-assisted arthroplasty involve financially conflicted authors that were more likely to report robotically-favorable results [ 38 ]. The current authors have no such financial conflict of interests related to the study and conceivably report less-biased results.…”

Section: Discussionmentioning

confidence: 99%

Total Knee Arthroplasty Hospital Costs by Time-Driven Activity-Based Costing: Robotic vs Conventional

et al. 2022

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Background Total knee arthroplasty (TKA) represents a major national health expenditure. The last decade has seen a surge in robotic-assisted TKA (roTKA); however, literature on the costs of roTKA as compared to conventional TKA (cTKA) is limited. The purpose of this study was to assess the costs associated with roTKA as compared to cTKA. Methods This was a retrospective cohort cost-analysis study of patients undergoing primary, elective roTKA or cTKA from July 2020 to March 2021. Time-driven activity-based costing (TDABC) was used to determine granular costs. Patient demographics, medical/surgical details, and costs were compared. Results A total of 2058 TKAs were analyzed (1795 cTKAs and 263 roTKAs). roTKA patients were more often male (50.2% vs 42.3%; P = .016), and discharged home (98.5% vs 93.7%; P = .017), and had longer operating room (OR) time (144.6 vs 130.9 minutes; P < .0001), and lower length of stay (LOS) (1.8 vs 2.1 days; P < .0001). roTKA costs were 2.17× greater for supplies excluding implant ( P < .0001), 1.18× for total supplies ( P < .0001), 1.12× for OR personnel ( P < .0001), and 1.05× for total personnel ( P = .0001). Implant costs were similar ( P = .076), but 0.98× cheaper for post-anesthesia care unit personnel ( P = .018) and 0.84× for inpatient personnel ( P < .0001). Overall hospital costs for roTKA were 1.10× more than cTKA ( P < .0001). Conclusion roTKA had higher total hospital costs than cTKA. Despite a lower LOS, the longer OR time with higher supply and personnel costs resulted in a costlier procedure. Understanding the costs of roTKA is essential when considering the value (ie, outcomes per dollars spent) of this modern technology.

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The Impact of Author Financial Conflicts on Robotic-Assisted Joint Arthroplasty Research

Cited by 30 publications

References 47 publications

Robotic‐arm assisted versus manual total hip arthroplasty: Systematic review and meta‐analysis of radiographic accuracy

Robotic‐arm assisted versus manual total hip arthroplasty: Systematic review and meta‐analysis of radiographic accuracy

Robotic Versus Manual Total Knee Arthroplasty in High Volume Surgeons: A Comparison of Cost and Quality Metrics

Total Knee Arthroplasty Hospital Costs by Time-Driven Activity-Based Costing: Robotic vs Conventional

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