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CT planning studies for robotic total knee arthroplasty.

Walaa Abdelfadeel1, Nicklaus Houston1, Andrew Star1

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|June 2, 2020
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The cost of preoperative CT scans for robotic-assisted total knee arthroplasty (RATKA) is low. Eliminating the radiologist

Keywords:
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Area of Science:

  • Orthopedic Surgery
  • Radiology
  • Health Economics

Background:

  • Robotic-assisted total knee arthroplasty (RATKA) requires preoperative imaging for surgical planning.
  • The cost-effectiveness of preoperative CT scans for RATKA is not fully understood.
  • Incidental findings on preoperative CT scans may impact patient management and healthcare costs.

Purpose of the Study:

  • To analyze the true costs of preoperative CT scans for RATKA planning.
  • To determine the value and impact of formal radiologist reports for these scans.
  • To assess the cost-benefit of incidental findings in preoperative RATKA imaging.

Main Methods:

  • Review of 194 CT reports from 176 patients undergoing primary RATKA.
  • Analysis of incidental findings in CT radiology reports that could alter patient management.
  • Recording and comparison of total scan payments (technical and professional components) for 330 patients across two institutions.

Main Results:

  • 82 incidental findings were noted in 61 CT studies; only one led to further testing.
  • Mean total payment for a preoperative CT scan was $446, with significant variation ($8 to $3,870).
  • Mean patient payment was $71, with wide institutional and insurance-based disparities.

Conclusions:

  • Preoperative CT scan costs are a minor component of the overall RATKA expense.
  • The professional component of the radiologist's report may be unnecessary, as no incidental findings changed management.
  • Further research should explore patient perspectives and the wide cost variations in preoperative imaging.