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J Knee Surg 2023; 36(10): 1077-1086
DOI: 10.1055/s-0042-1749083
Original Article

A 90-Day Episode-of-Care Analysis Including Computed Tomography Scans of Robotic-Arm Assisted versus Manual Total Knee Arthroplasty

David A. Gregory
1   Department of Orthopaedic Surgery, Baker Tilly Virchow Krause LLP, Madison, Wisconsin
,
Andrea Coppolecchia
2   Division of Joint Replacement, Stryker Orthopaedics, Mahwah,, New Jersey
,
Dennis J. Scotti
3   Department of Orthopaedic Surgery, Fairleigh Dickinson University, Teaneck, New Jersey
,
Zhongming Chen 
4   Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
,
Michael A. Mont
4   Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
,
David Jacofsky
5   Department of Orthopaedic Surgery, The CORE Institute, Phoenix, Arizona
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Abstract

In this observational, retrospective study, we performed economic analyses between robotic arm-assisted total knee arthroplasty (RATKA) and manual total knee arthroplasty (MTKA). Specifically, we compared: (1) index costs including computed tomography (CT) scans; (2) 90-day postoperative health care utilization, (3) 90-day episode-of-care (EOC) costs, and (4) lengths of stay between CT scan-based robotically-assisted versus MTKAs. A large national database, Blue Health Intelligence (BHI), was used for RATKAs and MTKAs performed between April 1, 2017 and September 30, 2019. Based on strict inclusion–exclusion criteria, with propensity score matching, 4,135 RATKAs and 4,135 MTKAs were identified and analyzed. Index costs to the payer for RATKA patients were found to be less than those for MTKA patients ($29,984 vs. $31,280, p <0.0001). Overall, 90-day EOC costs for RATKA patients were found to be less than that for MTKA patients in the inpatient and outpatient settings. This also holds true for the use of skilled nursing facilities, pharmacies, or other services. In conclusion, the results from our study show that RATKA were associated with lower costs than MTKAs, even when including the cost of CT scans. These results are of marked importance given the emphasis to contain and reduce health care costs.

Keywords

episode-of-care - computed tomography scans - robotic-arm assisted manual - total knee arthroplasty


Publication History

Received: 03 March 2022

Accepted: 16 March 2022

Article published online:
11 July 2022

© 2022. Thieme. All rights reserved.

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