The Learning Curve Associated with Robotic Total Knee Arthroplasty

Area of Science:

• Orthopaedic Surgery
• Surgical Technology
• Robotics in Medicine

Background:

• Robotic-assisted surgery is increasingly adopted in orthopaedics.
• A learning curve is expected for new surgical technologies like robotic-assisted total knee arthroplasty (TKA).
• Understanding operative times is crucial for assessing the efficiency of robotic TKA.

Purpose of the Study:

• To assess and compare operative times for robotic-assisted versus manual total knee arthroplasty (TKA).
• To determine the learning curve associated with robotic-assisted TKA for individual surgeons.
• To establish the time frame for surgeons to achieve proficiency in robotic TKA.

Main Methods:

• Analysis of 240 robotic-assisted TKAs performed by two surgeons.
• Sequential grouping of cases into 20-case cohorts to map the learning curve.
• Comparison of operative times between early and late robotic-assisted cases and matched manual cases.

Main Results:

• Both surgeons showed a significant decrease in operative times from their first 20 to last 20 robotic-assisted cases (Surgeon 1: 81 to 70 min; Surgeon 2: 117 to 98 min).
• Operative times for the last 20 robotic-assisted cases were comparable to manual TKA times (Surgeon 1: 70 vs. 68 min; Surgeon 2: 98 vs. 95 min).
• A learning curve was established, indicating proficiency is reached within a relatively short period.

Conclusions:

• Robotic-assisted TKA demonstrates a learning curve, with operative times decreasing significantly as surgeons gain experience.
• Experienced orthopaedic surgeons can achieve operative times comparable to manual TKA within months of adopting robotic assistance.
• The findings suggest that robotic TKA can be integrated efficiently into practice without substantial increases in operative time.