The Perception and Adoption of Robotic Total Joint Arthroplasty: An Analysis of the United States.

Abstract

The use of robotic assistance in total hip arthroplasty (THA) and total knee arthroplasty (TKA) continues to rise in the United States (US). The purpose of this study was to investigate the perspectives and rationale for the adoption of robotics by practicing orthopaedic surgeons. We aimed to assess 1) trends in the use of and interest in robotic-assisted total joint arthroplasty (TJA); 2) robotic use by procedure type and manufacturer; and 3) the most important reasons for the use of robotic assistance in TJA. A double-blinded online survey was distributed across the US to orthopaedic surgeons who perform total joint arthroplasty (TJA) in October 2023. There were 200 surgeons included who met the selection criteria, which included being in practice for at least two years, having no consulting agreement with a major manufacturer, and performing a minimum of 100 arthroplasty procedures annually. The survey asked questions regarding interest in robotic-assisted TJA, current use of robotics, use patterns between different arthroplasty procedures, and reasons for these utilization decisions. Respondents were asked to describe their responses over a five-year period, from 2019 to 2023. Survey responses were collected and analyzed with descriptive statistics. Over the five-year period, there was a notable rise in surgeons who have already adopted robotics, from 10% in 2018 to 35% in 2023. Surgeons who had fewer years in practice (less than 10) had the greatest interest in robotics, and this percentage has increased yearly. Partial knee arthroplasty (PKA) had the greatest utilization of robotics among all arthroplasty procedures, at 43%, followed by TKA and THA at 36 and 20%, respectively. Surgical efficiency and ease of use were rated by respondents to be the most important reasons for the implementation of robotics in TJA. Robotic assistance in TJA continues to rise in the US, with the greatest interest seen among younger surgeons. Surgeons found that intraoperative factors, including ease of use and efficiency, were the most important reasons for adopting robotics. Further studies are needed to better evaluate longer-term use patterns and clinical outcomes.