HEALTHCARE UTILIZATION AND COSTS OF CT-BASED ROBOTIC-ARM ASSISTED VERSUS MANUAL TOTAL KNEE ARTHROPLASTY COHORTS: REAL-WORLD EVIDENCE FROM THE PREMIER HEALTHCARE DATABASE
Author(s)
Christina K. O'Neill, BS1, Róisín Leahy, PhD2, Anusha Guntupalli, MS1, Andrea Coppolecchia, MPH1, Michael A. Mont, MD3;
1Stryker, Mahwah, NJ, USA, 2Stryker, Anngrove, Cork, Ireland, 3The Rubin Institute for Advanced Orthopedics, Baltimore, MD, USA
1Stryker, Mahwah, NJ, USA, 2Stryker, Anngrove, Cork, Ireland, 3The Rubin Institute for Advanced Orthopedics, Baltimore, MD, USA
OBJECTIVES: Total knee arthroplasty (TKA) is among the most commonly performed orthopaedic procedures in the United States, with volumes projected to rise substantially in the coming decades. Robotic-arm assisted TKA (RA-TKA) has emerged as a technology, with studies showing improved surgical precision and patient outcomes compared to manual techniques. However, real-world evidence comparing healthcare utilization and costs between computed tomography (CT)-based RA-TKA and manual TKA (M-TKA) cases using large administrative databases remains limited.
METHODS: This retrospective cohort study utilized the Premier Healthcare Database to identify adults (≥ 18 years) undergoing elective TKA from June 2016 to 2025. RA-TKA procedures were identified using an algorithm incorporating ICD-10-PCS procedure codes, robotic procedure codes, preoperative CT imaging within 60 days, and implant-specific chargemaster data. M-TKA was defined by the absence of robotic procedure codes and no preoperative CT imaging for 60 days. Exclusions included bilateral or staged bilateral procedures, unicompartmental knee arthroplasty or total hip arthroplasty within 90 days, in-hospital mortality, malignancy, trauma, ankylosis, infection, and missing data. Baseline variables included demographics, payer type, physician and hospital characteristics, and fixation type. Propensity score adjustment will be performed to account for baseline differences. Outcomes included 30- and 90-day revisit and readmission rates, lengths of stay, operative times, discharge statuses, and episode-of-care costs.
RESULTS: Preliminary analysis identified more than 600,000 patients meeting inclusion and exclusion criteria. Baseline descriptive demographics were similar between the M‑TKA and RA‑TKA cohorts. In both cohorts the mean age was 68 years, approximately 60% of patients were women, and the majority of patients were white (85.4% in RA-TKA versus 82.0% in M-TKA). Analysis of healthcare utilization and cost outcomes is ongoing.
CONCLUSIONS: As RA-TKA adoption increases, real-world evidence is essential to inform clinical decision-making and value-based care. The final propensity-score-matched comparative results evaluating healthcare utilization and costs between RA-TKA and M-TKA cohorts will be presented.
METHODS: This retrospective cohort study utilized the Premier Healthcare Database to identify adults (≥ 18 years) undergoing elective TKA from June 2016 to 2025. RA-TKA procedures were identified using an algorithm incorporating ICD-10-PCS procedure codes, robotic procedure codes, preoperative CT imaging within 60 days, and implant-specific chargemaster data. M-TKA was defined by the absence of robotic procedure codes and no preoperative CT imaging for 60 days. Exclusions included bilateral or staged bilateral procedures, unicompartmental knee arthroplasty or total hip arthroplasty within 90 days, in-hospital mortality, malignancy, trauma, ankylosis, infection, and missing data. Baseline variables included demographics, payer type, physician and hospital characteristics, and fixation type. Propensity score adjustment will be performed to account for baseline differences. Outcomes included 30- and 90-day revisit and readmission rates, lengths of stay, operative times, discharge statuses, and episode-of-care costs.
RESULTS: Preliminary analysis identified more than 600,000 patients meeting inclusion and exclusion criteria. Baseline descriptive demographics were similar between the M‑TKA and RA‑TKA cohorts. In both cohorts the mean age was 68 years, approximately 60% of patients were women, and the majority of patients were white (85.4% in RA-TKA versus 82.0% in M-TKA). Analysis of healthcare utilization and cost outcomes is ongoing.
CONCLUSIONS: As RA-TKA adoption increases, real-world evidence is essential to inform clinical decision-making and value-based care. The final propensity-score-matched comparative results evaluating healthcare utilization and costs between RA-TKA and M-TKA cohorts will be presented.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
CO19
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal), STA: Surgery