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Updated: May 14, 2026

The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
Re-learning curve for conventional total knee arthroplasty following 30 consecutive computer-assisted total knee
Luke T Nicholson1, David Trofa, Eric Smith
1Department of Orthopaedics, Tufts Medical Center/Tufts University School of Medicine, Boston, MA 02111, USA.
Abstract:
A learning curve for returning to conventional total knee arthroplasty (TKA) after using computer-assisted (CAS) TKA has not yet been established. In this study, the postoperative mechanical axes of the first 30 consecutive CAS TKAs performed by a single surgeon were compared to his subsequent 120 conventionally performed TKAs. A "re-learning curve" of 30 conventional TKAs was necessary to attain an average postoperative mechanical axis statistically indistinguishable from the average CAS mechanical axis (1.99°). This is a trend of which surgeons should be aware when converting from CAS TKA to conventional TKA. As a secondary goal, the authors identify the first clinical parameter, preoperative deviation from neutral mechanical axis, that may potentially serve as a guide for the selective use of CAS in TKA.