Healthcare resource utilization for VELYS™ robotic-assisted solution compared to manual surgery for total knee arthroplasty

Abstract

BACKGROUND: This study compared healthcare resource utilization associated with the use of VELYS™ Robotic-assisted solution (VRAS) vs. manual surgery for primary total knee arthroplasty (TKA). METHODS: Electronic medical records of patients undergoing TKA from a single surgeon at a US critical access hospital (manual surgery: 2019 to 2020; VRAS: 2022 to 2023) were reviewed. The primary clinical/health economic outcome of interest was pain medication use (morphine milligram equivalents [MMEs]). The secondary clinical/health economic outcome of interest was hospital length of stay (LOS). Multivariable logistic regression models accounted for potential confounding. RESULTS: Among 452 TKA cases (mean [SD] age 67.4 [9.0] years, 50.2% male), 215 patients (47.6%) received VRAS and 237 (52.4%) received manual surgery. VRAS patients were slightly older (67.9 vs. 66.9 years) and a greater proportion were male (55.7 vs. 46.0%). Unadjusted analyses found manual surgery patients used nearly twice as much pain medication (mean [SD] 156.2 [104.1] vs. 86.2 [83.6] MMEs; p < 0.001) and had longer mean (SD) and median LOS (mean 1.5 [0.7] vs. 1.1 [0.5] days and median 1.2 vs. 1.0 days; p < 0.001). After adjustment for age, sex, body mass index, and American Society of Anesthesiology score, manual surgery patients had 1.7 times higher MME consumption (p < 0.05) and 1.4 times longer LOS (p < 0.05). Further adjustment for differences in baseline comorbidities showed more pronounced differences: manual patients had 2.3 times higher MME consumption (p < 0.05) and 1.8 times longer LOS (p < 0.05). CONCLUSIONS: VRAS may facilitate significantly reduced pain medication and shorter LOS with TKA.