Orthopedic surgery ·
Robotic hip and knee replacement show no overall revision difference; spinal arthroplasty code announced; Medicare add-on starts for P-15 graft
THE SHORT READ
Two National Joint Registry studies published Sept. 30 in The BMJ found no difference in overall revision risk between robotic and conventional knee or hip replacement. The American Medical Association (AMA) announced a Category I Current Procedural Terminology (CPT) code for posterior vertebral column arthroplasty, Premia Spine said. A Medicare add-on payment for a peptide bone graft used in lumbar fusion took effect Oct. 1, and the Food and Drug Administration (FDA) cleared an implant aimed at screw loosening in fusion constructs.
THE DETAILS
- Research Sept 30, 2026The BMJ target trial emulation studies used National Joint Registry data from 2018 to 2024 on 697,145 knee replacements, 22,111 of them robotic, and 666,283 total hip replacements, 10,203 of them robotic. Five-year implant survival for matched total knee replacements was 98.5% conventional and 98.6% robotic (hazard ratio 1.03), and for hips 98.8% in both groups (hazard ratio 0.96). Robotic hip replacement had a lower risk of revision for implant malposition, such as dislocation (hazard ratio 0.53). The authors said residual confounding could not be ruled out and cited higher capital and procedural costs.Sources: The BMJ (knee study), The BMJ (hip study)
- Payment Oct 1, 2026Premia Spine, maker of the TOPS System, said the American Medical Association announced Oct. 1 that its CPT Editorial Panel, at its September 2026 meeting, voted to establish the Category I code, effective Jan. 1, 2028. Premia describes TOPS as a motion-preserving alternative to fusion for patients with spinal stenosis and spondylolisthesis; the device received Food and Drug Administration premarket approval in June 2023. The company said its pivotal study found TOPS outperformed fusion at two years in grade 1 degenerative spondylolisthesis with stenosis.
- Payment Oct 1, 2026Cerapedics said the Centers for Medicare & Medicaid Services (CMS) granted new technology add-on payment status to PearlMatrix P-15 Peptide Enhanced Bone Graft, a drug-device combination product for skeletally mature patients with degenerative disc disease in the lumbar spine, effective Oct. 1. For qualifying inpatient cases, the payment covers up to 65% of the additional cost of the technology. CMS granted the status through its alternative pathway for products with Food and Drug Administration Breakthrough Device designation, the company said.
- FDA Sept 28, 2026SI-BONE announced the Food and Drug Administration (FDA) 510(k) clearance Sept. 28 for the Onyx system, designed to address loosening at the upper and lower instrumented vertebrae of a spinal fusion construct. The company said loosening occurs at those levels in as many as 27% of fusion constructs and that the risk is elevated in patients with low bone density. SI-BONE said Onyx is its first product for compromised bone intended for use outside the pelvis and its third platform with FDA breakthrough device designation.
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