Evidence map›Paper›PMID 40921892›Full record

ReviewJournal of robotic surgery2025

Robotic total hip and knee arthroplasty: economic impact and workflow efficiency.

Benjamin E Jevnikar, Shujaa T Khan, Ahmed K Emara, Khaled A Elmenawi, Matthew Deren, Nicolas S Piuzzi

Abstract readReview
In one paragraph

Review in Journal of robotic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 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

13 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. [Progress and future prospects of robot-assisted total hip arthroplasty].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026
    Review
  6. Article
  7. Article
  8. Review
  9. Review
  10. Article
  11. Article
  12. Article
  13. Article
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.

Benjamin E JevnikarDepartment of Orthopedic Surgery, Orthopedic and Rheumatology Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH, A4144195, USA.
Shujaa T KhanDepartment of Orthopedic Surgery, Orthopedic and Rheumatology Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH, A4144195, USA.
Ahmed K EmaraDepartment of Orthopedic Surgery, Orthopedic and Rheumatology Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH, A4144195, USA.
Khaled A ElmenawiDepartment of Orthopedic Surgery, Orthopedic and Rheumatology Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH, A4144195, USA.
Matthew DerenDepartment of Orthopedic Surgery, Orthopedic and Rheumatology Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH, A4144195, USA.
Nicolas S PiuzziDepartment of Orthopedic Surgery, Orthopedic and Rheumatology Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH, A4144195, USA. piuzzin@ccf.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Robotic-assisted total joint arthroplasty (RA-TJA) is projected to account for 70% of all arthroplasties by 2030, yet its economic value and operational efficiency have yet to be thoroughly synthesized. While early literature emphasized technical precision, evolving payment models and implementation costs have shifted focus toward cost-effectiveness and workflow integration. To evaluate the economic and institutional viability of RA-TJA by synthesizing available evidence on capital costs, perioperative expenses, learning curves, throughput, and long-term adoption trends. This review also considers market competition, global uptake, and the need for standardized outcomes reporting. A narrative literature review of published cost analyses, real-world efficiency studies, and policy-relevant frameworks was conducted. Literature addressing per-case cost variability, bundled payments, and implementation strategies was analyzed. Emerging economic models and global diffusion patterns were incorporated to contextualize long-term feasibility. Robotic platforms consistently incur higher upfront and perioperative costs than manual or navigated arthroplasty. However, in both high- and low-volume institutions, these costs may be offset by reduced complications, shorter hospital stays, and improved discharge metrics. Efficiency gains are amplified through procedural clustering and experienced teams. Adoption is accelerating globally, facilitated by leasing models and market competition, yet value remains highly dependent on institutional context. A lack of standardized outcome reporting and platform heterogeneity limits cross-study comparisons. Ongoing, long-term, multicenter randomized trials are expected to address these evidence gaps. Robotic assistance can improve the efficiency and precision of arthroplasty procedures, with the potential for substantial cost-effectiveness when optimized. Institutions adopting this technology can expect improved outcomes by leveraging local surgical volume and infrastructure. Wider integration will be facilitated by robust long-term data, standardized outcome metrics, and continuous innovation that aligns with value-based care models.

Indexed as

Arthroplasty, Replacement, HipArthroplasty, Replacement, KneeRobotic Surgical ProceduresWorkflowCost-Benefit AnalysisHumansArthroplastyHealth care costsHipKneeReplacementRobotics

Identifiers

PMID40921892
PMCPMC12417245

What OpenQuestion holds

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LicenceCC BY
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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.