Cost-Effectiveness Analysis of Robotic Arthroplasty

Robotic-assisted technology was introduced into orthopedic procedures nearly two decades ago with the hope of reducing human error by improving mechanical alignment and joint kinematics. Four robotic systems are approved variably for use in the United States today as technologies for improving implant precision in total knee, total hip, unicompartmental knee, and patellofemoral arthroplasty procedures. Although evidence has strongly supported significant improvements in radiographic outcomes, the long-term clinical benefits and their associated economic implications are not well defined. Further complicating matters, institutions considering the implementation of robotic-assisted systems should anticipate other potential associated costs (e.g., capital investments, maintenance fees, disposable costs, and preoperative imaging requirements) specific to the different platforms. These costs can add a significant financial burden to the overall value of these procedures depending on the negotiated financial agreement, robotic life span, and institutional case volume. Therefore, in order to remain economically feasible, these costs must be offset by high case volumes and improvements in outcomes. Given the current performance-based healthcare environment, it is crucial that clinicians ensure that value-based goals are achieved.