机器人辅助全膝关节置换术在美国：到2030年，全国采用趋势将达到70%

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-05-21 DOI:10.1016/j.jcot.2025.103069

Shujaa T. Khan , Ahmed K. Emara , Guangjin Zhou , Siran M. Koroukian , Cleveland Clinic Adult Reconstruction Research, Nicolas S. Piuzzi , Cleveland Clinic Adult Reconstruction Research consists of, Ignacio Pasqualini , Alvaro Ibaseta , Benjamin E. Jevnikar , Nicholas K. Schiltz , Matthew Deren

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引用次数: 0

摘要

背景：机器人辅助在全膝关节置换术（TKA）中越来越普遍。本研究旨在(1)预测到2030年美国人工（M-TKA）和机器人辅助TKA （RA-TKA）的数量和百分比，(2)比较RA-TKA和M-TKA之间的医疗保健利用率和术后并发症。方法采用ICD-10和CPT编码查询2012 - 2020年全国住院患者数据库和全国门诊手术服务数据库中人工和机器人tka的数据。使用对数二项回归模型估计未来RA-TKA的利用率。从回归模型预测的概率乘以每个年龄-性别-医院区域亚组到2030年每年的预计人口。结果ra - tka的利用率由2008年的0.01%提高到2020年的8.5%。预测表明，到2030年，RA-TKA预计将占2631972例tka的70.1% （95% CI: 65.5-74.5）。与RA-TKA相比，M-TKA表现出更高的机械、非机械和感染性并发症发生率(1.8% vs. 0.7%；30.1% vs. 24.9%；分别为1.8%和0.7%,p <；0.0001)。RA-TKA患者出院后接受家庭保健的比例更高(88.7%对73%，p <；0.0001)，且住院时间较短(1.9天对2.8天，p <；0.0001)。到2030年，ra - tka预计将占美国所有tka的70%以上。随着机器人技术的日益整合，需要对基于培训、成本效率和长期结果的价值进行更深入的探索，以了解广泛采用RA-TKA作为常规程序的后果。然而，本研究的局限性在于其回顾性设计，依赖于可能导致错误分类的行政编码，以及2018年之前门诊数据的不可获得性。

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Robotic-assisted total knee arthroplasty in the USA: Nationwide adoption trends towards 70 % by 2030

Background

Robotic-assistance is becoming more prevalent in total knee arthroplasty (TKA). This study aims to (1) project the volume and percentage of manual (M-TKA) and robotic-assisted TKA (RA-TKA) in the United States through 2030, and (2) compare healthcare utilization and postoperative complications between RA-TKA and M-TKA.

Methods

Two national databases (Nationwide Inpatient Database and National Ambulatory Surgery Service Database) from 2012 to 2020 were queried for manual and robotic TKAs using ICD-10 and CPT codes. Future RA-TKA utilization was estimated using log-binomial regression modeling. The predicted probabilities from the regression models were multiplied by the projected population of each age-sex-hospital region subgroup per year through 2030.

Results

RA-TKA utilization increased from 0.01 % in 2008 to 8.5 % in 2020. Projections indicate that by 2030, RA-TKA is expected to represent 70.1 % (95 % CI:65.5–74.5) of the 2,631,972 TKAs performed. M-TKA exhibited higher incidences of mechanical, non-mechanical, and infective complications compared to RA-TKA (1.8 % vs. 0.7 %; 30.1 % vs. 24.9 %; 1.8 % vs. 0.7 % respectively, p < 0.0001). A greater proportion of RA-TKA patients were discharged to home health care (88.7 % vs. 73 %, p < 0.0001), and they had shorter hospital stays (1.9 vs. 2.8 days, p < 0.0001).

Conclusion

RA-TKA is anticipated to make up more than 70 % of all TKAs performed in the United States by 2030. The increasing integration of robotic technology raises the need for deeper explorations into value based on training, cost efficiency and long-term outcomes to understand the ramifications of widespread adoption of RA-TKA as a routine procedure. However, this study is limited by its retrospective design, reliance on administrative coding which may lead to misclassification, and the unavailability of outpatient data prior to 2018.

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.