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Marktübersicht: Roboterassistierte Endoprothetik

Aktuelle Robotersysteme, Lernkurven und Kostenanalyse

Market overview: Robotic-assisted arthroplasty

Current robotic systems, learning curve and cost analysis

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Zusammenfassung

Die roboterassistierte Endoprothetik findet seit Jahren einen rasanten Einzug in die klinische Routine. Die führenden Endoprothesenhersteller haben mittlerweile alle Robotersysteme auf dem Markt platziert, welche sich jedoch technisch untereinander deutlich unterscheiden. Die Systeme werden aktuell nach dem Autonomiegrad (aktiv vs. semiaktiv vs. passiv) und der Daten‑/Bildquelle (Bildgestützt: CT vs. Röntgen, bildlos) eingeteilt. Einzelne Systeme bieten bereits jetzt schon die Möglichkeit, roboterassistiert oder navigiert Hüftendoprothesen zu implantieren. Im folgenden Übersichtsartikel sollen die aktuell führend verwendeten Robotersysteme vorgestellt und hinsichtlich der Eigenschaften verglichen werden. Im Weiteren soll auf die Analyse der Lernkurven für die unterschiedlichen Systeme und auf aktuell vorhandene Kostenanalysemodelle eingegangen werden sowie ein Ausblick auf künftige Entwicklungen und Herausforderungen gegeben werden.

Abstract

Robotic-assisted arthroplasty has been rapidly entering clinical routine in recent years. The leading endoprosthesis manufacturers have all meanwhile placed robotic systems on the market, which, however, differ significantly from one another technically. Current systems are currently classified according to the degree of autonomy (active vs. semi-active vs. passive) and the data/image source (image-based: CT vs. X‑ray, imageless). Some systems already offer the possibility of robotic-assisted or navigated implantation of hip endoprostheses. In the following review article, the currently leading robotic systems will be presented and compared with regard to their characteristics. Furthermore, the analysis of the learning curves for the different systems, currently available cost analysis models and an outlook on future developments and challenges will be given.

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Abbreviations

CAS:

Computerassistierten Chirurgie

EOC :

„Episode of care“

FDA :

Food and Drug Administration

HTEP :

Hüfttotalendoprothese

ICER :

„Incremental cost-effectiveness ratio“

KIS :

Krankenhausinformationssystem

PFJ :

Patellofemoralprothetik

PRD :

Endoprothesenregister Deutschland

PROM :

„Patient-reported outcome measures“

PSI :

„Patient specific instruments“

QALY :

„Quality adjusted life years“

RA :

„Robotic-assisted“

THA :

Hüfttotalendoprothetik

TKA :

Knietotalendoprothetik

UKA :

Schlittenprothetik

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  1. Orthopädische Klinik der MHH im Diakovere Annastift, Anna-von-Borries-Str. 1–6, 30625, Hannover, Deutschland

    Lars-René Tuecking,  Max Ettinger,  Henning Windhagen &  Peter Savov

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Correspondence to Lars-René Tuecking.

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L.-R. Tuecking, M. Ettinger, H. Windhagen und P. Savov weisen auf folgende Beziehungen hin: Forschung und Lehre für Smith & Nephew, Stryker, Aesculap, Medacta.

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Tuecking, LR., Ettinger, M., Windhagen, H. et al. Marktübersicht: Roboterassistierte Endoprothetik. Orthopädie 51, 727–738 (2022). https://doi.org/10.1007/s00132-022-04286-x

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