Technology and cost-effectiveness in knee arthroplasty: computer navigation and robotics.

Our aim in this article is to describe the impact that navigation technology has had on the market share of a community hospital and, specifically, to determine whether a high-volume surgeon using these technologies actually costs the hospital more than other surgeons at the same hospital and more than national means. In addition, we develop a comparable cost-effectiveness model for robotic technology in unicompartmental knee arthroplasty to demonstrate the potential cost-effectiveness at the same hospital.

[1]  Daniel L Riddle,et al.  Yearly incidence of unicompartmental knee arthroplasty in the United States. , 2008, The Journal of arthroplasty.

[2]  K. Bozic,et al.  An overview of economic issues in computer-assisted total joint arthroplasty. , 2007, Clinical orthopaedics and related research.

[3]  N. Confalonieri,et al.  Computer-assisted technique versus intramedullary and extramedullary alignment systems in total knee replacement: a radiological comparison. , 2005, Acta orthopaedica Belgica.

[4]  D. Simpson,et al.  Blood loss after total knee replacement: effects of computer-assisted surgery. , 2005, The Journal of bone and joint surgery. British volume.

[5]  M Jakopec,et al.  Hands-on robotic unicompartmental knee replacement: a prospective, randomised controlled study of the acrobot system. , 2006, The Journal of bone and joint surgery. British volume.

[6]  Judith M Mathias Orthopedic navigation: questions about long-term results and costs. , 2007, OR manager.

[7]  W. Mihalko,et al.  The variability of intramedullary alignment of the femoral component during total knee arthroplasty. , 2005, The Journal of arthroplasty.

[8]  A. Tosteson,et al.  Impact of hospital volume on the economic value of computer navigation for total knee replacement. , 2008, The Journal of bone and joint surgery. American volume.

[9]  Martin Buxton,et al.  Early assessment of the likely cost-effectiveness of a new technology: A Markov model with probabilistic sensitivity analysis of computer-assisted total knee replacement , 2006, International Journal of Technology Assessment in Health Care.

[10]  Y Kalairajah,et al.  Are systemic emboli reduced in computer-assisted knee surgery?: A prospective, randomised, clinical trial. , 2006, The Journal of bone and joint surgery. British volume.

[11]  D. Zurakowski,et al.  Alignment in total knee arthroplasty. A comparison of computer-assisted surgery with the conventional technique. , 2004, The Journal of bone and joint surgery. British volume.

[12]  M. Bolognesi,et al.  Computer Navigation versus Standard Instrumentation for TKA: A Single-Surgeon Experience , 2005, Clinical orthopaedics and related research.

[13]  B. Hanson,et al.  Navigated total knee replacement. A meta-analysis. , 2007, The Journal of bone and joint surgery. American volume.

[14]  K. Bozic,et al.  The cost-effectiveness of computer-assisted navigation in total knee arthroplasty. , 2007, The Journal of bone and joint surgery. American volume.

[15]  Pak Lin Chin,et al.  Randomized control trial comparing radiographic total knee arthroplasty implant placement using computer navigation versus conventional technique. , 2005, The Journal of arthroplasty.

[16]  R. Sinha,et al.  Outcomes of robotic arm-assisted unicompartmental knee arthroplasty. , 2009, American journal of orthopedics.

[17]  L. Borgquist,et al.  Use of unicompartmental instead of tricompartmental prostheses for unicompartmental arthrosis in the knee is a cost-effective alternative. 15,437 primary tricompartmental prostheses were compared with 10,624 primary medial or lateral unicompartmental prostheses. , 1999, Acta orthopaedica Scandinavica.

[18]  W. Breidahl,et al.  Computer-assisted knee arthroplasty versus a conventional jig-based technique. A randomised, prospective trial. , 2004, The Journal of bone and joint surgery. British volume.

[19]  M. Tingart,et al.  Radiological results of image-based and non-image-based computer-assisted total knee arthroplasty , 2004, International Orthopaedics.

[20]  Richard L Wixson,et al.  Computer assisted navigation in total knee arthroplasty: improved coronal alignment. , 2005, The Journal of arthroplasty.

[21]  R. K. Mielke,et al.  [Navigation in knee endoprosthesis implantation--preliminary experiences and prospective comparative study with conventional implantation technique]. , 2001, Zeitschrift fur Orthopadie und ihre Grenzgebiete.

[22]  K. Buehler,et al.  Computer assisted navigation in total knee arthroplasty: comparison with conventional methods. , 2005, The Journal of arthroplasty.