Cost-effectiveness of a novel, fluoroscopy-based robotic-assisted total hip arthroplasty system: A Markov analysis

Background The purpose of this study was to assess the cost-effectiveness of a novel, fluoroscopy-based robotic-assisted total hip arthroplasty (RA-THA) system compared to a manual unassisted technique (mTHA) up to 5 years post-operatively.Methods A Markov model was constructed to compare the cost-effectiveness of RA-THA and mTHA. Cost-effectiveness was defined as an Incremental Cost-Effectiveness Ratio (ICER) <$50 000 or $100 000 per Quality Adjusted Life Year (QALY).Results RA-THA patients experienced lower costs compared to mTHA patients at 1 year ($20 865.12 +/- 9897.52 vs. $21 660.86 +/- 9909.15; p < 0.001) and 5 years ($23 124.57 +/- 10 045.48 vs. $25 756.42 +/- 10 091.84; p < 0.001) post-operatively. RA-THA patients also accrued more QALYs (1-year: 0.901 +/- 0.117 vs. 0.888 +/- 0.114; p < 0.001; 5-years: 4.455 +/- 0.563 vs. 4.384 +/- 0.537 p < 0.001). Overall, RA-THA was cost-effective (1-year ICER: $-61 210.77; 5-year ICER: $-37 068.31).Conclusions The novel, fluoroscopy-based RA-THA system demonstrated cost-effectiveness when compared to manual unassisted THA.