The learning curve in robotic assisted knee arthroplasty is flattened by the presence of a surgeon experienced with robotic assisted surgery

Abstract

Purpose The purpose of this study was to investigate the learning curve associated with robotic assisted knee arthroplasty (RAS KA). Therefore, the evaluation of the influence of an experienced surgeon on the overall team performance of three surgeons regarding the learning curve in RAS KA was investigated. It was hypothesized that the presence of an experienced surgeon flattens the learning curve and that there was no inflection point for the learning curve of the surgical team. Methods Fifty-five cases consisting of 31 total knee arthroplasties (TKA) and 24 unicompartmental arthroplasties (UKA) performed by three surgeons during 2021 were prospectively investigated. Single surgeon and team performance for operation time learning curve and inflection points were investigated using cumulative sum analysis (CUSUM). Results A downward trend line for individual surgeons and the team performance regarding the operation time learning curve was observed. No inflexion point was observed for the overall team performance regarding TKA and UKA. The surgeon that performed all cases with the assistance of the experienced surgeon had significantly shorter surgical times than the surgeon that only occasionally received assistance from the experienced surgeon (p = 0.004 TKA; p = 0.002 UKA). Conclusion The presence of an experienced surgeon in robotically assisted knee arthroplasty can flatten the learning curve of the surgical team formerly unexperienced in robotic assisted systems. Manufacturers should provide expanded support during initial cases in centres without previous experience to robotic assisted knee arthroplasty. Level of evidence III.

NAVIO RATKA shows similar rates of hemoglobin‐drop, adverse events, readmission and early revision vs conventional TKA: a single centre retrospective cohort study

“…In terms of surgical time, most literature reports that MAKO RATKA achieves steady-state time neutrality after 7-80 cases [41,42]. Similar to the NAVIO RATKA results in this study, two studies have reported a continued decrease in MAKO RATKA surgical time without identiication of an inlection point up to 1 year after implementation of the new technology in clinical practice [19,33]. The results of this study have implications for clinical practice.…”

No Benefit of Robotic-Assisted over Computer-Assisted Surgery for Achieving Neutral Coronal Alignment in Total Knee Arthroplasty

“…Pannu et al demonstrated 110 cases are needed to finally achieve the planned limb alignment when MAKO RAS system is utilized, seemingly aMA, although not explicitly described in the study 22 . In the present study, 20 initial cases were excluded due to the initial learning curve, but the results observed match previous learning curve studies demonstrating little to no learning curve in terms of implant position 13,23,24 . Winnock de Grave demonstrated superior outcomes of inverse kinematic when compared to aMA 7 .…”

“…Inclusion criteria were: TKA either using CAS or RAS between 01/2022 and 05/2022. Exclusion criteria were: First 20 cases using RAS due to the learning curve since a RASexperienced surgeon was not present 13 and cases where functional alignment was utilized This article is protected by copyright. All rights reserved.…”

Trends in Computer-Assisted Surgery for Total Knee Arthroplasty in Germany: An Analysis Based on the Operative Procedure Classification System between 2010 to 2021

“…Despite the promising results of R-TKA, there are also some concerns associated with the regular usage of robotic surgery, as many authors and opponents of robotic TKA cite increased surgery times and costs [ 44 , 45 ]. However, several studies have demonstrated a relatively short learning curve regarding the duration of surgery, with similar operation room time for R-TKA compared to manual instrumentation after 10 to 20 cases [ 46 , 47 , 48 ].…”