Evidence map›Paper›PMID 42227258›Full record

SynthesisEFORT open reviews2026

Economic evaluation of robotic-assisted versus manual total hip arthroplasty: a systematic review of cost and clinical outcomes.

Warran Wignadasan, Christos Dragonas, Andreas Fontalis, Marc Jean Berna, Pit Putzeys, Romir Patel, Fares S Haddad

Abstract readSystematic Review
In one paragraph

Synthesis in EFORT open reviews, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

7 authors.

Warran WignadasanDepartment of Trauma and Orthopaedic Surgery, University College Hospital, London, United Kingdom.ORCID https://orcid.org/0000-0001-5695-1516
Christos DragonasRoyal London Hospital, London, United Kingdom.
Andreas FontalisDepartment of Trauma and Orthopaedic Surgery, University College Hospital, London, United Kingdom.
Marc Jean BernaDepartment of Orthopaedics, Hôpitaux Robert Schuman, Luxembourg, Luxembourg.
Pit PutzeysDepartment of Orthopaedics, Hôpitaux Robert Schuman, Luxembourg, Luxembourg.
Romir PatelUniversity of Birmingham Medical School, Birmingham, United Kingdom.
Fares S HaddadDepartment of Trauma and Orthopaedic Surgery, University College Hospital, London, United Kingdom.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Total hip arthroplasty (THA) is a widely performed, cost-intensive procedure with growing demand due to an aging population. While manual THA (mTHA) offers reliable outcomes, robotic-arm-assisted THA (RATHA) has emerged as a technologically advanced alternative with potential clinical advantages. However, its economic value remains uncertain due to high capital and maintenance costs. This systematic review aimed to compare the economic and clinical outcomes of RATHA versus mTHA. Methods: A systematic search of MEDLINE, Embase, and Cochrane Library was conducted (1990-May 2024) following PRISMA guidelines. Studies comparing RATHA and mTHA in adult populations were included. Quality was assessed using the Newcastle-Ottawa scale, and data on costs, clinical outcomes, and patient-reported outcome measures (PROMs) were extracted and synthesized. Results: Seven studies (two Markov models, one prospective cohort, and four retrospective analyses) covering over 1.3 million patients were included. RATHA was associated with higher procedural costs but often yielded lower total 90-day care costs due to shorter hospital stays, fewer readmissions, and reduced rehabilitation needs. Cost-utility analyses showed favorable incremental cost-effectiveness ratios (ICERs), particularly in high-volume centers. Clinical outcomes were comparable or slightly better for RATHA, with some evidence of improved PROMs. Conclusion: RATHA may be cost-effective in high-volume settings, with potential for long-term clinical and financial benefits. However, variation in cost methodologies and healthcare models, along with high initial investment, highlights the need for further high-quality studies with standardized economic reporting and patient-centered outcomes.

Indexed as

cost comparisoncost-effectivenessrobotic THA

Identifiers

PMID42227258
PMCPMC13240625

What OpenQuestion holds

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Registered trials

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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.