OBJECTIVES: Total knee arthroplasty (TKA) is a successful and frequently performed surgical procedure that reduce disability caused by end-stage osteoarthritis. Moreover, robotic-assisted total/partial knee arthroplasty surgery is known to improve implantation accuracy, however short-term outcomes like costs are not clear. The objective of this study was to compare the short-term economic outcomes of r-TKA (Navio/CORI^◊ system Smith+Nephew Memphis TN) with c-TKA using the Premier PINC AI Healthcare Database (PHD) a US hospital inpatient and outpatient database.

METHODS: Patients who underwent elective primary TKA between 2017 and September 30, 2022, in the PDH were identified using diagnosis-related group (DRG) codes 469 and 470 for knee replacement while robotics was identified from billing data and/or CPT/ICD-10 codes. Information collected included gender, age, Charlson Comorbidity Index scores, and 1:3 propensity score matching was used to ensure a balanced cohort in terms of baseline patient, hospital, and clinical characteristics. Statistical analysis included between group comparisons of costs using a generalized linear model and length of hospital stay (LOS) using poison regression.

RESULTS: A total of 10,966 patients were included in the analysis, of these, 2,246 were r-TKA and 8,220 were c-TKA. Mean age was 66, 42.5% were females and 79% were total TKA in both groups. There was a 46% reduction in mean LOS (0.97 vs 0.53 days) p<0.0001 in favor of r-TKA. There was a statistically significant reduction in index admission and 90-day episode of care costs $945 p<0.0001 and $590 p=0.0006 respectively in favor of r-TKA.

CONCLUSIONS: TKA patients who received r-TKA had significantly lower length of hospital stay, lower index admission and 90-day costs when compared to patients who received c-TKA. Further analysis involving a larger sample size of r-TKA recipients and additional stratification of sub-group analyses is required to fully assess significant between-group differences in clinical outcomes.