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• Posted May 10, 2024

The Pros & Cons of Robotic Knee Replacement Surgery

Robot-assisted total knee replacements tend to have better outcomes on average, a new study reports.

Unfortunately, there's a downside"having a surgical robot assist a human surgeon can make the procedure much more costly.

Patients who had a robot-assisted knee replacement stayed in the hospital nearly a half-day less, and were significantly less likely to develop complications like infections, excessive blood loss, and fractures, dislocations or mechanical complications of their prosthetic, researchers report.

However, robotic knee replacements cost an average $2,400 more than the conventional procedure, researchers found.

Researchers said they hope the study will help doctors and patients make educated decisions regarding the best option for knee surgery.

"As the population continues to age, there will be a greater demand for safe and effective total knee replacement surgery, also known as total knee arthroscopy (TKA),"lead researcher Dr. Senthil Sambandam, an assistant professor of orthopedic surgery at UT Southwestern Medical Center in Dallas, said in a news release.

In knee replacement procedures, surgeons cut away bone damaged by arthritis and replace it with metal and plastic parts.

Surgeons perform most knee replacements by hand, judging how much bone to remove based on training and expertise.

However, a growing number of these procedures are performed using surgical robots that rely on imaging scans or anatomical landmarks to determine where to cut.

Using a robot theoretically improves accuracy and safety, but some studies have suggested these improvements are minimal or non-existent.

To compare the two approaches, researchers compared medical records for more than 540,000 people who underwent a traditional knee replacement with more than 17,000 who had a robot-assisted procedure. The operations all took place between 2016 and 2019.

In this analysis, the cost of robotic knee replacement was as much as $15,000 higher than in earlier comparison studies, researchers noted.

The higher cost of the robotic procedure comes from the acquisition of the robot equipment"which typically costs millions of dollars"as well as the disposable equipment needed for the operation, researchers said.

However, robot-assisted knee replacement might be a more cost-effective option in hospitals that perform a large number of the procedures, because fewer complications might offset the higher cost, Sambandam said.

The study found that robot-assisted knee replacement had:

• 88% lower risk of prosthetic dislocation.

• 68% lower risk of prosthetic mechanical complication.

• 64% lower risk of pulmonary embolism.

• 63% lower risk of excessive bleeding requiring a transfusion.

• 53% lower risk of pneumonia.

• 52% lower risk of deep vein thrombosis.

• 27% lower risk of anemia due to blood loss.

The new study appears in the Archives of Orthopaedic and Trauma Surgery.

More information

Johns Hopkins Medicine has more about knee replacement.

SOURCE: UT Southwestern Medical Center, news release, May 7, 2024