Robotic total knee arthroplasty safely reduces length of stay in an Asian public healthcare system
Aims: Around the world, the emergence of robotic technology has improved surgical precision and accuracy in total knee arthroplasty (TKA). This territory-wide study compares the results of various robotic TKA (R-TKA) systems with those of conventional TKA (C-TKA) and computer-navigated TKA (N-TKA)....
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| Format: | Article |
| Language: | English |
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The British Editorial Society of Bone & Joint Surgery
2025-01-01
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| Series: | Bone & Joint Open |
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| Online Access: | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.61.BJO-2024-0184.R1 |
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| author | Kai C. A. Chan Amy Cheung Ping-Keung Chan Michelle H. Luk Kwong Y. Chiu Henry Fu |
| author_facet | Kai C. A. Chan Amy Cheung Ping-Keung Chan Michelle H. Luk Kwong Y. Chiu Henry Fu |
| author_sort | Kai C. A. Chan |
| collection | DOAJ |
| description | Aims: Around the world, the emergence of robotic technology has improved surgical precision and accuracy in total knee arthroplasty (TKA). This territory-wide study compares the results of various robotic TKA (R-TKA) systems with those of conventional TKA (C-TKA) and computer-navigated TKA (N-TKA). Methods: This is a retrospective study utilizing territory-wide data from the Clinical Data Analysis and Reporting System (CDARS). All patients who underwent primary TKA in all 47 public hospitals in Hong Kong between January 2021 and December 2023 were analyzed. Primary outcomes were the percentage use of various robotic and navigation platforms. Secondary outcomes were: 1) mean length of stay (LOS); 2) 30-day emergency department (ED) attendance rate; 3) 90-day ED attendance rate; 4) 90-day reoperation rate; 5) 90-day mortality rate; and 6) surgical time. Results: A total of 8,492 knees from 7,746 patients were included in the study. Overall robotic use had risen to 20.4% (2023 Q3 to Q4: 355/1,738) by the end of 2023, with Mako being the most popular at 10.3% (179/1,738). R-TKA had the shortest mean LOS compared with N-TKA and C-TKA (5.5 vs 6.3 and 7.1 days, respectively; p < 0.001). Only Mako (9.7%) demonstrated reduced 90-day ED attendance compared to C-TKA (13.1%; p = 0.009), Cori/Navio (15.0%; p = 0.005), and Rosa (16.4%; p < 0.001). No differences in 90-day reoperation rate and mortality were observed between all groups. Mean surgical times were longer in R-TKA groups by 20.6 minutes (p < 0.001). Conclusion: R-TKA use has increased in recent years, and has been shown to reduce hospital stay despite having a slightly longer surgical time, proving a promising candidate to alleviate the burden on healthcare systems. Individual differences between R-TKA systems contributed to variable clinical outcomes. Cite this article: Bone Jt Open 2024;6(1):12–20. |
| format | Article |
| id | doaj-art-087f38cfd0eb41f0962b892f20889b11 |
| institution | Kabale University |
| issn | 2633-1462 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | The British Editorial Society of Bone & Joint Surgery |
| record_format | Article |
| series | Bone & Joint Open |
| spelling | doaj-art-087f38cfd0eb41f0962b892f20889b112025-01-28T05:38:53ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Open2633-14622025-01-0161122010.1302/2633-1462.61.BJO-2024-0184.R1Robotic total knee arthroplasty safely reduces length of stay in an Asian public healthcare systemKai C. A. Chan0https://orcid.org/0009-0005-6217-2291Amy Cheung1https://orcid.org/0000-0002-4992-6176Ping-Keung Chan2https://orcid.org/0000-0002-1969-0895Michelle H. Luk3https://orcid.org/0000-0001-6859-9011Kwong Y. Chiu4https://orcid.org/0000-0001-9284-5817Henry Fu5https://orcid.org/0000-0001-7520-6845Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, ChinaDepartment of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, ChinaDepartment of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, ChinaDepartment of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, ChinaDepartment of Orthopaedics and Traumatology, Hong Kong Sanatorium Hospital, Hong Kong SAR, ChinaDepartment of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, ChinaAims: Around the world, the emergence of robotic technology has improved surgical precision and accuracy in total knee arthroplasty (TKA). This territory-wide study compares the results of various robotic TKA (R-TKA) systems with those of conventional TKA (C-TKA) and computer-navigated TKA (N-TKA). Methods: This is a retrospective study utilizing territory-wide data from the Clinical Data Analysis and Reporting System (CDARS). All patients who underwent primary TKA in all 47 public hospitals in Hong Kong between January 2021 and December 2023 were analyzed. Primary outcomes were the percentage use of various robotic and navigation platforms. Secondary outcomes were: 1) mean length of stay (LOS); 2) 30-day emergency department (ED) attendance rate; 3) 90-day ED attendance rate; 4) 90-day reoperation rate; 5) 90-day mortality rate; and 6) surgical time. Results: A total of 8,492 knees from 7,746 patients were included in the study. Overall robotic use had risen to 20.4% (2023 Q3 to Q4: 355/1,738) by the end of 2023, with Mako being the most popular at 10.3% (179/1,738). R-TKA had the shortest mean LOS compared with N-TKA and C-TKA (5.5 vs 6.3 and 7.1 days, respectively; p < 0.001). Only Mako (9.7%) demonstrated reduced 90-day ED attendance compared to C-TKA (13.1%; p = 0.009), Cori/Navio (15.0%; p = 0.005), and Rosa (16.4%; p < 0.001). No differences in 90-day reoperation rate and mortality were observed between all groups. Mean surgical times were longer in R-TKA groups by 20.6 minutes (p < 0.001). Conclusion: R-TKA use has increased in recent years, and has been shown to reduce hospital stay despite having a slightly longer surgical time, proving a promising candidate to alleviate the burden on healthcare systems. Individual differences between R-TKA systems contributed to variable clinical outcomes. Cite this article: Bone Jt Open 2024;6(1):12–20.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.61.BJO-2024-0184.R1total knee arthroplastyosteoarthritisrobotic surgeryrobotic arm-assisted knee replacementknee replacementrobotic total knee arthroplastytotal knee arthroplasty (tka)kneesreoperationnavigated total knee arthroplastyclinical outcomesprimary tkachi-squared testt-testconventional total knee arthroplasty |
| spellingShingle | Kai C. A. Chan Amy Cheung Ping-Keung Chan Michelle H. Luk Kwong Y. Chiu Henry Fu Robotic total knee arthroplasty safely reduces length of stay in an Asian public healthcare system Bone & Joint Open total knee arthroplasty osteoarthritis robotic surgery robotic arm-assisted knee replacement knee replacement robotic total knee arthroplasty total knee arthroplasty (tka) knees reoperation navigated total knee arthroplasty clinical outcomes primary tka chi-squared test t-test conventional total knee arthroplasty |
| title | Robotic total knee arthroplasty safely reduces length of stay in an Asian public healthcare system |
| title_full | Robotic total knee arthroplasty safely reduces length of stay in an Asian public healthcare system |
| title_fullStr | Robotic total knee arthroplasty safely reduces length of stay in an Asian public healthcare system |
| title_full_unstemmed | Robotic total knee arthroplasty safely reduces length of stay in an Asian public healthcare system |
| title_short | Robotic total knee arthroplasty safely reduces length of stay in an Asian public healthcare system |
| title_sort | robotic total knee arthroplasty safely reduces length of stay in an asian public healthcare system |
| topic | total knee arthroplasty osteoarthritis robotic surgery robotic arm-assisted knee replacement knee replacement robotic total knee arthroplasty total knee arthroplasty (tka) knees reoperation navigated total knee arthroplasty clinical outcomes primary tka chi-squared test t-test conventional total knee arthroplasty |
| url | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.61.BJO-2024-0184.R1 |
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