Related Experiment Video
Updated: Feb 5, 2026

Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Learning curve with a new primary total knee arthroplasty implant: a multicenter perspective with more than 2000
John-Paul Whittaker1, Kimberly A Dwyer2, James Howard3
1Robert Jones and Agnes Hunt Orthopaedic Hospital, England, UK.
Background:
This study provides an example for evaluating learning curve when introducing a new knee system.
Methods:
Thirty-five investigators across 22 sites prospectively implanted 843 subjects with currently available products (group A). Seventy-seven investigators across 48 sites prospectively implanted 2330 subjects with the ATTUNE Knee System; in which the first 10 subjects for each surgeon were the learning curve cases (group B, N = 611), and the later subjects were designated as group C (N = 1719). Surgical time, rates of intraoperative and early postoperative complications, and patient-reported outcome measures (PROMs) at a minimum of 1 year were compared.
Results:
Mean (standard deviation) surgical time was 72.0 (21.6) minutes for group A, 83.0 (24.2) for group B, and 72.1 (24.1) for group C (P < .001 for group B vs group C; P = .955 for group C vs group A). Intraoperative, early (<90 day) complication rates, and PROMs were similar for all groups.
Conclusions:
The new knee system learning curve was characterized by a slightly longer surgical time with no negative impact on complications or PROMs.
Level Of Evidence:
III.
Related Concept Videos
Knee Joint
A total of seven ligaments support the knee joint. The patellar ligament, which is also attached to the quadriceps femoris...
Psychodynamic Perspectives on Personality
Psychodynamic theorists argue that unconscious...
Criticisms of the Evolutionary Perspective
Evolutionary psychology provides one explanation for these findings, suggesting...
The Behavioral Perspective on Personality
Social Cognitive Perspective on Personality
Heating and Cooling Curves
For instance, the addition of heat raises the temperature of a solid; the amount of heat absorbed depends on the heat capacity of the solid (q = mcsolidΔT). According to thermochemistry, the relation between the amount of heat absorbed or released by a substance, q, and its...

