Early Clinical and Economic Outcomes for the VELYS™ Robotic-Assisted Solution (VRAS) Compared to Manual Instrumentation for Total Knee Arthroplasty.

Robotic-assisted total knee arthroplasty (TKA) has been developed to improve functional outcomes after TKA by increasing surgical precision of bone cuts and soft tissue balancing, thereby reducing outliers. The DePuy Synthes VELYS™ Robotic Assisted Solution (VRAS), is one of the latest entrants in the robotic TKA market. Currently, there is limited evidence investigating early patient and economic outcomes associated with the use of VRAS. The Premier Healthcare Database was analyzed to identify patients undergoing manual TKA with any implant system compared to a cohort of robotic-assisted TKAs using VRAS between September 1, 2021, and February 28, 2023. The primary outcome was all cause and knee related all-setting revisits within 90-days post TKA. Secondary outcomes included number of inpatient revisits (readmission), operating room time, discharge status, and hospital costs. Baseline covariate differences between the two cohorts were balanced using fine stratification methodology and analyzed using generalized linear models. The cohorts included 866 VRAS and 128,643 manual TKAs that had 90-day follow-up data. The rates of both all-cause and knee-related all-setting follow up visits were significantly lower in the VRAS cohort compared to the manual TKA cohort (13.86% vs. 17.19%; Mean Difference (MD): -3.34 [95% CI: -5.65 to -1.03] and 2.66% vs. 4.81%; MD: -2.15 [-3.23 to -1.08], respectively, p-value < 0.01) at 90-day follow-up. The incidence of knee-related inpatient readmission was also significantly lower (53%) for VRAS compared to manual TKA. There was no significant difference between total cost of care at 90-day follow-up between VRAS and manual TKA cases. On average, the operating room time was higher for VRAS compared to manual TKA (138 vs. 134 minutes). In addition, the discharge status and revision rates were similar between the cohorts. The use of VRAS for TKA is associated with lower follow up visits and knee related readmission rates in the first 90 days postoperative. The total hospital cost was similar for both VRAS and manual TKA cohort without accounting for the purchase of the robot.