Increasing Utilization Trends of Robotic Assistance in Orthopaedic Surgery.

Introduction: Robotic-assisted surgeries in orthopaedics have increased, particularly in hip and knee arthroplasty and spine surgeries. This study evaluates national utilization trends of robotic-assisted orthopaedic surgeries and demographic and geographic distribution of patients undergoing these surgeries.

Methods: A retrospective cohort study was conducted on patients who underwent total hip arthroplasty, total and partial knee arthroplasty, or spine arthrodesis from 2017 to 2023 using the TriNetX database. Relevant International Classification of Diseases, 10th Revision, and Current Procedural Terminology codes identified patients who underwent a primary surgery with a corresponding robot-assisted code on the same day. Temporal trends in procedural volume were analyzed, and multivariable logistic regression assessed sociodemographic factors associated with receiving robotic surgery.

Results: A total of 809,802 patients underwent 1,072,714 surgeries, of which 57,920 (5.1%) used robotics. Overall, utilization increased from 3.0% in 2017 to 6.7% in 2023, with knee arthroplasty rising from 5.7% to 13.8% and spine arthrodesis from 0.2% to 1.3% (P < 0.0001). Logistic regression demonstrated a higher utilization among female individuals (odds ratio [OR], 1.16), Asian patients (OR, 1.15), and married individuals (OR, 1.38). Black (OR, 0.39) and Hispanic/Latino (0.63) patients were less likely to receive robotic surgeries. Regionally, patients in the Midwest were more likely to receive robotic-assisted surgeries compared with the Northeast (OR, 2.43), whereas those in the South (OR, 0.72) and West (OR, 0.50) were less likely.

Conclusions: Robotic-assisted orthopaedic surgery continues to expand, particularly in knee arthroplasty and spine fusion. Although advancements in surgical technology offer potential benefits, ensuring both clear demonstration of long-term clinical benefit and equitable access remains an ongoing challenge.