Robot knee surgery faces cost challenge
The cost/benefit of robot assisted knee surgery: Prof. Nick London explores why, for the time being, the computer still says ‘no’.
The recent meeting of the European Knee Society in Valencia saw a robust discussion about robot assisted knee surgery between advocates of the process who are starting to produce some supportive medium-term data, and those of us who feel that whilst the robots’ time may come, the data doesn’t yet suggest that time is now.
To be clear, that’s not necessarily a result of any damning evidence against robot assisted surgery; it’s more the effect of little evidence to support its value.
The research to date has yet to show any significant advantage to using a robot assisted surgeon over an unassisted expert (human) surgeon. It remains to be proven that the addition of robotics reduces risk compared to regular knee replacement surgery performed by high volume knee surgeons.
And then there’s the robot elephant in the room: the additional time and resource required in setting the robot to work costs money. The presentations we saw outlined that huge additional cost and confirmed that as yet there’s no significant evidence of the cost being balanced by surgical benefit.
More data required
I recently spent time with Sebastian Parratte in Abu Dhabi. He’s a surgeon with a considerable track record in good, clinical academic research in orthopaedic surgery and he has begun evaluating robotic knee replacements. We need to see more authoritative research like this in order to understand the point at which we reach the tipping point – the point at which risk, benefit and cost are all improved by robot assisted surgeons.
We’ve said this before, but it bears repeating: we remain of the opinion that as technology improves, capabilities will increase as risk and cost diminish. At that point we may well be advocating the use of robot assisted technology. But not yet.
That’s why we continue to monitor the situation closely, and why we welcome more independent analysis.