Evidence map›Paper›PMID 34549322›Full record

ArticleInternational orthopaedics2022

Implementation of robotic-assisted total knee arthroplasty in the public health system: a comparative cost analysis.

Daniel Steffens, Sascha Karunaratne, Kate McBride, Sanjeev Gupta, Mark Horsley, Brett Fritsch

Abstract read
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In one paragraph

Article in International orthopaedics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  10. No difference in surgical time and total theatre time between robotically assisted and computer assisted total knee arthroplasty.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Daniel SteffensSurgical Outcomes Resource Centre (SouRCe), Royal Prince Alfred Hospital, Level 9, Building 89, Missenden Road, Camperdown, Sydney, NSW, 2050, Australia. Daniel.Steffens@health.nsw.gov.au.ORCID http://orcid.org/0000-0002-9715-860X
Sascha KarunaratneSurgical Outcomes Resource Centre (SouRCe), Royal Prince Alfred Hospital, Level 9, Building 89, Missenden Road, Camperdown, Sydney, NSW, 2050, Australia.ORCID http://orcid.org/0000-0001-7518-0307
Kate McBrideSurgical Outcomes Resource Centre (SouRCe), Royal Prince Alfred Hospital, Level 9, Building 89, Missenden Road, Camperdown, Sydney, NSW, 2050, Australia.ORCID http://orcid.org/0000-0003-4898-7230
Sanjeev GuptaDepartment of Orthopaedic Surgery, Royal Prince Alfred Hospital (RPAH), Sydney, NSW, Australia.
Mark HorsleyDepartment of Orthopaedic Surgery, Royal Prince Alfred Hospital (RPAH), Sydney, NSW, Australia.ORCID http://orcid.org/0000-0003-3466-4377
Brett FritschDepartment of Orthopaedic Surgery, Royal Prince Alfred Hospital (RPAH), Sydney, NSW, Australia.ORCID http://orcid.org/0000-0002-2268-2298

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeRobotic-assisted total knee arthroplasty (TKA) may improve the precision of bone preparation and component alignment when compared to the conventional surgical approach; however, the detailed cost analysis of robotic-assisted TKA is lacking. This study aims to compare in-hospital costs between robotic-assisted and computer-navigated TKA.

methodsPatients undergoing primary TKA at a public hospital in Sydney between October 2018 and June 2019 were included. Patient demographics, surgical outcomes and in-hospital cost variables including, staff, critical care, emergency department, diagnostic, prosthesis, operating room, ward and other related costs until the discharge to the community were collected. Differences across in-hospital costs between robotic-assisted and computer-navigated TKA were compared using independent Student's t-tests.

resultsOf the 258 primary TKAs, 181 (70.2%) were computer-navigated and 77 (29.8%) robotic-assisted. Surgical time (p < 0.001) and operating time (p < 0.001) were both significantly shorter in computer-navigated TKA, while robotic-assisted TKA cases were more likely to be discharged directly home without extended in-patient rehabilitation (p = 0.014). When removing the capital costs of surgical equipment and maintenance, there was no difference in total in-hospital cost between computer-navigated ($19,512.3) and robotic-assisted TKA ($18,347.1; p = 0.179). When these capital costs were included, the mean in-hospital cost of robotic-assisted surgery was $21,507.6 compared to $19,659.7 for computer-navigated TKA (p = 0.034).

conclusionsThe total in-hospital cost, during the implementation period of robotic-assisted TKA, is comparable with computer-navigated TKA. Robotic-assisted TKA was significantly more expensive when the upfront cost of the robotic system and maintenance costs were included. Longer term cost benefit of robotic-assisted TKA should be investigated in future studies.

Indexed as

Arthroplasty, Replacement, KneeOsteoarthritis, KneeRobotic Surgical ProceduresCost-Benefit AnalysisHumansKnee JointPublic HealthComputer navigatedCostRobotic assistedTotal knee arthroplasty

Identifiers

PMID34549322

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.