Remily Ethan A, Nabet Austin, Sax Oliver C, Douglas Scott J, Pervaiz Sahir S, Delanois Ronald E
Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, MD, USA.
Arthroplast Today. 2021 Apr 30;9:46-49. doi: 10.1016/j.artd.2021.04.003. eCollection 2021 Jun.
The introduction of robotic technologies into the field of arthroplasty ushered in promises of increased precision and superior outcomes over conventional methods. However, the effect on outcomes in total hip arthroplasty (THA) remains debatable, particularly when considering the additional financial burden created by the addition of robotics. The purpose of this study is to examine total cost of care, length of stay (LOS), and postoperative complications in robotic-assisted vs conventional THA recipients.
A retrospective review of the Mariner database was performed within PearlDiver Technologies for patients undergoing THA from 2010 to 2018 (n = 714,859). Patients with robotic-assisted procedures were matched with patients undergoing conventional THA at a 1:1 ratio based on age, sex, Charlson Comorbidity Index, smoking, and obesity status (n = 4630). LOS, total cost of care, readmission rates, and medical and surgical outcomes were examined.
Robotic-assisted patients had shorter average LOS (3.4 vs 3.7 days, = .001). The mean cost for robotic-assisted patients was $1684 and $1759 less at 90 days and 1 year, respectively (both = .001). Readmission rates were higher for robotic-assisted patients at 1 year (7.8 vs 6.6%; = .001), while surgical outcomes were not significantly different at all timepoints (all > .498). Robotic-assisted patients demonstrated significantly higher blood transfusion rates (4.4 vs 3.2%; = .001).
Robotic-assisted THA was associated with minimal decreases in LOS and costs as compared to conventional methods. However, robotics was associated with slightly higher readmissions and blood transfusions.
机器人技术引入关节置换领域，带来了比传统方法更高的精度和更好结果的前景。然而，机器人技术对全髋关节置换术（THA）结果的影响仍存在争议，尤其是考虑到增加机器人技术所带来的额外经济负担时。本研究的目的是比较机器人辅助与传统THA患者的护理总成本、住院时间（LOS）和术后并发症。
在PearlDiver Technologies内对Mariner数据库进行回顾性分析，纳入2010年至2018年接受THA的患者（n = 714,859）。根据年龄、性别、Charlson合并症指数、吸烟和肥胖状况，将接受机器人辅助手术的患者与接受传统THA的患者按1:1比例进行匹配（n = 4630）。对住院时间、护理总成本、再入院率以及医疗和手术结果进行了检查。
机器人辅助手术的患者平均住院时间较短（3.4天对3.7天，P = .001）。机器人辅助手术患者在90天和1年时的平均费用分别比传统手术患者少1684美元和1759美元（均P = .001）。机器人辅助手术患者1年时的再入院率较高（7.8%对6.6%；P = .001），而在所有时间点手术结果无显著差异（均P > .498）。机器人辅助手术患者的输血率显著更高（4.4%对3.2%；P = .001）。
与传统方法相比，机器人辅助THA在住院时间和成本方面仅有微小降低。然而，机器人技术与稍高的再入院率和输血率相关。
