Trends of Utilization and 90-Day Complication Rates for Computer-Assisted Navigation and Robotic Assistance for Total Knee Arthroplasty in the United States From 2010 to 2018

Background: Computer-assisted navigation (CAN) and robotic assistance (RA) for total knee arthroplasty (TKA) are gaining in popularity. The purpose of this study is to update the literature on United States technology-assisted TKA trends of national utilization, regional utilization, and 90-day comp...

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Autores principales:	Ilya Bendich, MD, MBA, Milan Kapadia, BS, Kyle Alpaugh, MD, Alioune Diane, BE, Jonathan Vigdorchik, MD, Geoffrey Westrich, MD
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Total knee arthroplasty Computer navigation Robotic-assistance Technology-assisted arthroplasty Utilization Complications Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/668ccd8ac85e4e858d02aa44973d2fd9
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spelling	oai:doaj.org-article:668ccd8ac85e4e858d02aa44973d2fd92021-11-14T04:33:57ZTrends of Utilization and 90-Day Complication Rates for Computer-Assisted Navigation and Robotic Assistance for Total Knee Arthroplasty in the United States From 2010 to 20182352-344110.1016/j.artd.2021.08.005https://doaj.org/article/668ccd8ac85e4e858d02aa44973d2fd92021-10-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2352344121001394https://doaj.org/toc/2352-3441Background: Computer-assisted navigation (CAN) and robotic assistance (RA) for total knee arthroplasty (TKA) are gaining in popularity. The purpose of this study is to update the literature on United States technology-assisted TKA trends of national utilization, regional utilization, and 90-day complication rates requiring readmission. Methods: Patients who underwent primary, elective TKA between 2010 and 2018 were retrospectively identified in the PearlDiver All Payer Claims Database (PearlDiver Technologies Inc.). TKAs were classified as conventional, CAN, or RA based on International Classification of Diseases nineth or tenth revision and Current Procedural Technology codes. Annual rates and regional trends of each type of TKA were reported. Ninety-day complications requiring readmission for each group were captured. Multivariable logistic regression was used to identify odds ratios (OR) for all-cause readmission based on TKA modality. Results: Of the 1,307,411 elective TKAs performed from 2010 to 2018, 92.8% were conventional, and 7.7% were technology-assisted (95.2% CAN and 4.9% RA). RA-TKA had the greatest increase in utilization (+2204%). The Western region had the highest utilization of technologies for TKA, while the Midwestern region had the lowest. Ninety-day postoperative complications requiring readmission were highest for conventional TKA and lowest for RA-TKA. RA-TKA (OR 0.68; 97.5% confidence interval 0.56-0.83, P < .001) and CAN-TKA (OR 0.93; 97.5% confidence interval 0.88-0.97, P < .05) had significantly lower odds of all-cause 90-day complications requiring readmission than conventional TKA. Conclusion: Utilization of RA-TKA and CAN-TKA continues to rise across the United States. The use of these technologies is associated with a lower OR of readmission within 90 days postoperatively.Ilya Bendich, MD, MBAMilan Kapadia, BSKyle Alpaugh, MDAlioune Diane, BEJonathan Vigdorchik, MDGeoffrey Westrich, MDElsevierarticleTotal knee arthroplastyComputer navigationRobotic-assistanceTechnology-assisted arthroplastyUtilizationComplicationsOrthopedic surgeryRD701-811ENArthroplasty Today, Vol 11, Iss , Pp 134-139 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Total knee arthroplasty Computer navigation Robotic-assistance Technology-assisted arthroplasty Utilization Complications Orthopedic surgery RD701-811
spellingShingle	Total knee arthroplasty Computer navigation Robotic-assistance Technology-assisted arthroplasty Utilization Complications Orthopedic surgery RD701-811 Ilya Bendich, MD, MBA Milan Kapadia, BS Kyle Alpaugh, MD Alioune Diane, BE Jonathan Vigdorchik, MD Geoffrey Westrich, MD Trends of Utilization and 90-Day Complication Rates for Computer-Assisted Navigation and Robotic Assistance for Total Knee Arthroplasty in the United States From 2010 to 2018
description	Background: Computer-assisted navigation (CAN) and robotic assistance (RA) for total knee arthroplasty (TKA) are gaining in popularity. The purpose of this study is to update the literature on United States technology-assisted TKA trends of national utilization, regional utilization, and 90-day complication rates requiring readmission. Methods: Patients who underwent primary, elective TKA between 2010 and 2018 were retrospectively identified in the PearlDiver All Payer Claims Database (PearlDiver Technologies Inc.). TKAs were classified as conventional, CAN, or RA based on International Classification of Diseases nineth or tenth revision and Current Procedural Technology codes. Annual rates and regional trends of each type of TKA were reported. Ninety-day complications requiring readmission for each group were captured. Multivariable logistic regression was used to identify odds ratios (OR) for all-cause readmission based on TKA modality. Results: Of the 1,307,411 elective TKAs performed from 2010 to 2018, 92.8% were conventional, and 7.7% were technology-assisted (95.2% CAN and 4.9% RA). RA-TKA had the greatest increase in utilization (+2204%). The Western region had the highest utilization of technologies for TKA, while the Midwestern region had the lowest. Ninety-day postoperative complications requiring readmission were highest for conventional TKA and lowest for RA-TKA. RA-TKA (OR 0.68; 97.5% confidence interval 0.56-0.83, P < .001) and CAN-TKA (OR 0.93; 97.5% confidence interval 0.88-0.97, P < .05) had significantly lower odds of all-cause 90-day complications requiring readmission than conventional TKA. Conclusion: Utilization of RA-TKA and CAN-TKA continues to rise across the United States. The use of these technologies is associated with a lower OR of readmission within 90 days postoperatively.
format	article
author	Ilya Bendich, MD, MBA Milan Kapadia, BS Kyle Alpaugh, MD Alioune Diane, BE Jonathan Vigdorchik, MD Geoffrey Westrich, MD
author_facet	Ilya Bendich, MD, MBA Milan Kapadia, BS Kyle Alpaugh, MD Alioune Diane, BE Jonathan Vigdorchik, MD Geoffrey Westrich, MD
author_sort	Ilya Bendich, MD, MBA
title	Trends of Utilization and 90-Day Complication Rates for Computer-Assisted Navigation and Robotic Assistance for Total Knee Arthroplasty in the United States From 2010 to 2018
title_short	Trends of Utilization and 90-Day Complication Rates for Computer-Assisted Navigation and Robotic Assistance for Total Knee Arthroplasty in the United States From 2010 to 2018
title_full	Trends of Utilization and 90-Day Complication Rates for Computer-Assisted Navigation and Robotic Assistance for Total Knee Arthroplasty in the United States From 2010 to 2018
title_fullStr	Trends of Utilization and 90-Day Complication Rates for Computer-Assisted Navigation and Robotic Assistance for Total Knee Arthroplasty in the United States From 2010 to 2018
title_full_unstemmed	Trends of Utilization and 90-Day Complication Rates for Computer-Assisted Navigation and Robotic Assistance for Total Knee Arthroplasty in the United States From 2010 to 2018
title_sort	trends of utilization and 90-day complication rates for computer-assisted navigation and robotic assistance for total knee arthroplasty in the united states from 2010 to 2018
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/668ccd8ac85e4e858d02aa44973d2fd9
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Trends of Utilization and 90-Day Complication Rates for Computer-Assisted Navigation and Robotic Assistance for Total Knee Arthroplasty in the United States From 2010 to 2018

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