Presentation (CTI)

OBJECTIVES: Total knee arthroplasty (TKA) is an effective surgical procedure, with over 100,000 surgeries performed annually in the UK. However, TKA is resource-intensive, with revision rates of 5-6% for primary surgeries, leading up to threefold higher costs. Robotic-assisted TKA can improve implant alignment and positioning while providing insights to enhance efficiency, optimizing healthcare resource utilization (HRU). This study aims to assess the economic impact of implementing the VELYS™ Robotic-Assisted Solution (VRAS) versus the manual approach in the UK.
METHODS: A Markov model with a 7-year horizon was developed to compare the budget impact of VRAS and manual TKA. Health states were defined by the occurrence of revision. Inputs were sourced from real-world data, the UK and Australian National Joint Registries, NHS England tariffs, and published literature. HRU-related costs were combined with VRAS service and disposable costs to estimate savings. Deterministic and probabilistic sensitivity analyses (DSA and PSA) were conducted.
RESULTS: VRAS implementation led to a reduction of 1.19 days in the mean length of stay, a decrease of 22 minutes in mean OR time, a reduction of 4 surgical trays per case, and a reduction of 1.08% in absolute revision risk. It was also associated with reduced rates of knee-related revisits (2.66% vs. 4.81%) and readmissions (0.69% vs. 1.46%) compared to the manual approach. Estimated cost savings were £943 per patient from the UK hospital perspective and £2,959 per patient from the healthcare payer perspective. DSA showed the model was most sensitive to length of stay and OR time. PSA showed mean (95% CrI) savings of £934 (£126-£1770) from the hospital perspective and £2,967 (£2,158-£3,797) from the payer perspective.
CONCLUSIONS: Using a robotic-assisted solution in TKA could deliver cost savings and efficiency gains in the UK through improved HRU and lower revision rates.