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Robotic Knee Surgery: Fewer Problems, More Expensive

LAS VEGAS -- Robotic-assisted total knee arthroplasty (TKA) procedures cost about 26% more than traditional procedures, according to a retrospective cohort study presented here, but patients spent fewer days in the hospital and suffered fewer complications.

Among more than 5,000 patients undergoing TKA procedures, the median cost was higher in the robotic-surgery group ($12,805) versus traditional treatment ($10,162), and operative time was longer (101 vs 94 minutes), reported Chris Neighorn, of Providence Health Services in Portland, Oregon, and colleagues.

But the complication rate was markedly lower (0.7% vs 2.4%), as was the median length of stay (1.2 vs 2.2 days, P<0.0001 for all comparisons), according to the presentation at the 2019 annual meeting of the American Academy of Orthopaedic Surgeons.

The findings provide more evidence that robotic orthopedic surgery isn't harmful to patients, said orthopedic surgeon Assem A. Sultan, MD, of Cleveland Clinic, who reviewed the findings for MedPage Today.

The new study joins others that show "either equal or superior functional and radiographic outcomes," Sultan said.

For the new study, researchers retrospectively reviewed 1,285 robotic TKA and 3,930 traditional TKA procedures at nine West Coast hospitals. All were performed by 16 surgeons with the Stryker MAKO robot over the past 2 years, and each surgeon was a veteran of at least 15 TKA surgeries.

There were slight differences between the two groups: Patients in the robotic TKA group were slightly younger and slightly less obese on average, and they had a lower baseline functional score. At follow-up, there was no difference in functional scores between the two groups.

The researchers did not adjust for confounders. "The largest would have been demographic differences and differences in follow-up. Hopefully, these could be sorted out in a follow-up, prospective study," said Kevin Fleming, MBA, a senior executive at Providence Health who oversaw the research.

Cleveland Clinic's Sultan, who was not involved in the current study, co-authored a 2018 review of studies on robotic TKA. The review reported that advantages of the technology "may include greater component accuracy and precision, soft-tissue protection, increased patient satisfaction, a short learning curve, optimal ergonomic design, and less surgeon and surgical team fatigue." Sultan's group also found that most studies so far have focused on short-term outcomes.

According to Fleming, the study findings suggest that hospitals should carefully study the financial impact of robotic surgery, which appears to come with a "significant learning curve" and higher costs.

"The capital acquisition costs and annual operating costs for the robots are significant when compared to non-robotic procedures," he said. "There are also disposable items used for each procedure. These costs, coupled with a learning curve to become efficient with the robot, impact the direct cost per procedure and the time needed to perform it."

Moving forward, more research into robotic orthopedic surgery is needed to fully understand the value of the technology, Sultan said, especially in light of the fact surgeons are trying it out in less complicated cases. "Most studies have focused on complications and readmissions," he said, "and there is limited literature on functional outcomes. We also need more studies focused on cost analysis, telling us what the cost implication is."

No funding for the study is reported. Neither Fleming nor Sultan report relevant disclosures.

Source: https://www.medpagetoday.com/meetingcoverage/aaos/78613

Robot-Assisted Knee Replacement Steward




The average surgery what to know about tachypnea time was.5 minutes longer in the robotic -assisted group than in the conventional laparoscopic group, but the robotic devices pelzman’s Picks: Facebook and Suicide Prevention didnt reduce the need to convert some of the operations to open surgery. Both the generation of high-quality evidence evaluating new procedures and then the utilization of this evidence to guide practice should remain priorities for surgical disciplines. But robotic -assisted surgery costs averaged US2678 (2272.67 euros) more than those associated with laparoscopic surgery, mainly as a study ties arthritis pain reliever to heart valve disease result of longer operating room times and higher supply costs. The system is operated by the surgeon through a console which controls the robot arm. In computer-assisted robotic surgery, a robot acts as an extension of the surgeons eyes and hands in a minimally invasive surgery to replace an arthritic knee. The Da Vinci robotic surgery system is used for conditions that affect the soft tissue and organs. About drugs simply

When compared to open surgery, da Vinci robotic surgery leaves a much smaller scar, may reduce the risk of infection through exposure to air, hands and surgical devices like suction and sponges and may reduce the overall recovery time after surgery. The ConforMIS IUni implant is a custom-made minimally invasive partial knee replacement alternative that allows doctors to preserve more of the patients ligaments, tendons and cartilage. Complications: Increased anesthesia time, increased surgical time, device malfunction. Two experts not connected to the study had mixed opinions about the results. There is only a 3-degree window in which to place the implant appropriately. (Reuters Health), robotic -assisted surgery is much more expensive than other minimally invasive surgeries, but it does not improve outcomes of surgery for kidney tumors and rectal cancers.


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Nycizyk

Robot -Assisted, knee, replacement, knee replacement surgery, also known as total knee or partial knee arthroplasty, can be life-altering for many patients who suffer from osteoarthritis and other joint problems. Not only are these surgeries significantly more expensive than routine surgery celery Juice: Healthy or Hype? (computer assisted surgery alone adds about 1,500 to each case, and the robot costs 1 million for the hospital to purchase but they increase the operating time and thus the risk of infection. Robotic-assisted surgery : more expensive, but not always more effective. The average surgery time was.5 minutes longer in the robotic-assisted group than in the conventional laparoscopic group, but the robotic devices didnt reduce the need to convert some of the operations to open surgery. Patients Who May Benefit from. Robotic -Assisted Total, knee, replacement During total knee replacement surgery, surgeons replace all three compartments of the knee.

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Usafasaz

Patients for whom total knee replacement, rather than partial knee replacement, is the best option have severe arthritis, stiffness or deformity (crookedness). The new procedure is more expensive than conventional joint replacement surgery and is still in the early days, so are the proposed improved clinical outcomes worth the extra cost? We take a look at the pros and cons of robotic joint replacement surgery. In computer-assisted robotic surgery, a robot acts as an extension of the surgeons eyes and hands in a minimally invasive surgery to replace an arthritic knee.The robotics help surgeons operate more effectively what the Number of Pushups You Can Do Says About Your Heart through a smaller incision. The study involved more than 200 patients who underwent knee replacement surgery and were then tracked for pain control during the first two days after their procedure. The cost of using the da Vinci robotic surgery system can be high. For the patient, it is not less expensive than other, but is generally 3,000 to 6,000 more than laparoscopic procedures.

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