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Related Experiment Videos

Dynamic sensor-balanced knee arthroplasty: can the sensor "train" the surgeon?

Colin Y L Woon1, Kaitlin M Carroll1, Stephen Lyman1

  • 1Hospital for Special Surgery, New York, NY, USA.

Arthroplasty Today
|July 10, 2019
PubMed
Summary

Surgeons using dynamic tibial tray sensors for total knee arthroplasty (TKA) show a learning curve and skill "attrition" when the sensor is removed. Consistent sensor use leads to more predictable TKA balance.

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Area of Science:

  • Orthopedic surgery
  • Biomedical engineering
  • Surgical technology

Background:

  • Dynamic tibial tray sensors are increasingly used for coronal balancing in total knee arthroplasty (TKA).
  • Sensor-guided TKA aims for improved outcomes over traditional manual balancing.
  • The learning curve and impact on surgeon skill retention for sensor technology are not well understood.

Purpose of the Study:

  • To investigate the learning curve associated with dynamic tibial tray sensor use in TKA.
  • To assess whether sensor use improves manual TKA balance skills after sensor removal.

Main Methods:

  • A prospective, single-surgeon study of 104 consecutive TKAs was conducted.
  • Phase I (n=49) involved sensor-directed releases and load recording.
Keywords:
Computer-assisted surgeryDynamic sensorNavigationTotal knee arthroplasty

Related Experiment Videos

  • Phase II (n=55) used blinded sensor readings after manual balancing; cumulative summation and sequential probability ratio testing analyzed learning curves.

    • Main Results:

    • Sensor balance proficiency was easiest at 10° flexion, followed by 90°, and most difficult at 45°.
    • Manual balance skills declined most rapidly at 45° flexion after sensor removal.
    • The duration of steady-state periods was similar across both phases.

    Conclusions:

    • Consistent use of dynamic sensors in TKA demonstrates a surgeon learning curve.
    • Skill attrition occurs when sensors are removed, indicating a reliance on the technology.
    • Predictable sensor balance is achieved with continuous sensor application.