Technology-assisted TKA may yield lower 90-day readmission rates
Published results showed use of robotic-assisted and computer-assisted navigation total knee arthroplasty increased between 2010 to 2018 and were linked with lower odds of readmission within 90 days postoperatively vs. conventional TKA.
Using the PearlDiver All Payer Claims Database, Geoffrey Westrich, MD, and colleagues categorized 1,307,411 patients who underwent elective TKA between 2010 to 2018 into groups based on whether the procedure was conventional (92.8%) or technology assisted (7.7%) with either computer-assisted navigation (95.2%) or robotic assistance (4.9%). Researchers identified annual rates and regional trends of each type of TKA, as well as 90-day complications requiring readmission for each group. Researchers used multivariable logistic regression to identify odds ratios for all-cause readmission based on TKA modality.
Results showed the percentage of cases performed with technology assistance increased every year from 2010 to 2018, with the highest utilization of technologies for TKA found in the Western region of the United States and the lowest utilization found in the Midwestern region.
“Robotic technology has continued to improve over the past several years. It has taken off, and what we published was that when we looked at a time period from 2010 to 2018, robotic knee replacement increased more than 2,000%,” Westrich, professor of clinical orthopedic surgery at Hospital for Special Surgery and Cornell University Medical Center, told Healio Orthopedics. “So, there is a tremendous upswing of surgeons now using robotic assistance when they are doing a knee replacement.”
Westrich also noted use of robotic technology during TKA had a lower odds of all cause 90-day complications requiring readmission vs. conventional TKA. Researchers found a 0.27% and a 0.98% higher rate of all-cause readmission for conventional TKA compared with computer-assisted navigation TKA and robotic-assisted TKA, respectively.
“Although the numbers are small, it implies that for every 100 patients who undergo robotic-assisted knee replacement, we can avoid one readmission,” Westrich said. “That is powerful for the surgeon who is taking care of the patient, powerful for the hospital or ambulatory care center because we want to try to avoid having patients readmitted, but the people that it affects the most are the patients.”
According to Westrich, use of robotic technology allows surgeons to make an operation more accurate and reproducible with better outcomes and lower complication rates.
“There is definitely more computer navigation and robotics in the field of orthopedic surgery now than there ever has been, and it is only going to continue to get better,” Westrich said.