Theus-Steinmann Carlo, Calliess Tilman, Christen Bernhard, Tuecking Lars-René
articon Spezialpraxis für Gelenkchirurgie, Berner Prothetikzentrum BPZ, Hirslanden Salem-Spital, Schänzlistrasse 39, 3013, Bern, Schweiz.
Orthopädische Klinik der MHH, Diakovere Annastift, Hannover, Deutschland.
Orthopadie (Heidelb). 2025 Aug 6. doi: 10.1007/s00132-025-04696-7.
Robot-assisted technologies in total knee arthroplasty (TKA) have been introduced to increase implantation accuracy, minimize revisions, and ideally improve patient outcomes. However, concerns remain regarding increased costs and extended operating time. The aim of this study was to analyze the development of the cost structure of robot-assisted image-based knee arthroplasty in a specialized center over a 6-year period.
A retrospective cost analysis of image-based robot-assisted TKA based on data from 2024 was conducted and compared with results from a similar analysis from 2018. Specific parameters such as operating time, number and cost of surgical instrument trays, technology costs (leasing and service costs of the robot system), costs for robot-specific disposable materials, and preoperative CT imaging were considered. All costs were adjusted for inflation, converted to US dollars, and standardized to both a fixed case volume (n = 125 from 2018) and the actual case volume in 2024 (n = 457).
The fixed costs for the robotic technology itself (leasing and service fees per year) showed a slight increase between 2018 and 2024 (USD 151,000 vs. USD 225,620). However, due to the significant volume expansion achieved during this period, case-related technology costs were reduced by 60% (USD 1210 to USD 490). In addition, the costs for disposable materials were reduced by 27% (USD 600 to USD 440), and costs for preoperative CT imaging were reduced by 29% (USD 420 to USD 300). The average operating time was significantly reduced between 2018 and 2024 (73 min to 54 min) and was ultimately 5 min shorter than the comparable time for the manual technique (59 min). Overall, the average case-related total costs were reduced by 50% (USD 2600 to USD 1320) within 6 years.
The total case-related costs of robotic-assisted knee arthroplasty have been reduced by 50% over the past years. This was achieved mainly due to increased case volume and resulting cost efficiencies, shortened operative time, and reductions in disposable material costs. The technology itself has not become cheaper over the years.
全膝关节置换术（TKA）中的机器人辅助技术已被引入，以提高植入精度、减少翻修次数，并理想地改善患者预后。然而，对于成本增加和手术时间延长的担忧依然存在。本研究的目的是分析一家专业中心在6年期间基于图像的机器人辅助膝关节置换术成本结构的变化。
基于2024年的数据，对基于图像的机器人辅助TKA进行回顾性成本分析，并与2018年类似分析的结果进行比较。考虑了特定参数，如手术时间、手术器械托盘的数量和成本、技术成本（机器人系统的租赁和服务成本）、机器人专用一次性材料的成本以及术前CT成像成本。所有成本均进行了通货膨胀调整，换算为美元，并按照固定病例数量（2018年为n = 125）和2024年的实际病例数量（n = 457）进行标准化。
机器人技术本身的固定成本（每年的租赁和服务费）在2018年至2024年之间略有增加（15.1万美元对22.562万美元）。然而，由于在此期间实现了显著的病例数量增长，与病例相关的技术成本降低了60%（从1210美元降至490美元）。此外，一次性材料成本降低了27%（从600美元降至440美元），术前CT成像成本降低了29%（从420美元降至300美元）。2018年至2024年期间，平均手术时间显著缩短（从73分钟降至54分钟），最终比手动技术的可比时间（59分钟）短5分钟。总体而言，6年内与病例相关的平均总成本降低了50%（从2600美元降至1320美元）。
在过去几年中，机器人辅助膝关节置换术与病例相关的总成本降低了50%。这主要是由于病例数量增加以及由此产生的成本效益、手术时间缩短和一次性材料成本降低。多年来，技术本身并没有变得更便宜。
