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Time-Based Learning Curve for Robotic-Assisted Total Knee Arthroplasty: A Multicenter Study.

Zhongming Chen1, Manoshi Bhowmik-Stoker2, Matthew Palmer2

  • 1Department of Orthopaedic Surgery, Northwell Health, Lenox Hill Hospital, New York, New York.

The Journal of Knee Surgery
|March 7, 2022
PubMed
Summary

Robotic-assisted total knee arthroplasty (RA-TKA) shows a learning curve, with most surgeons improving within 12 cases. Steady-state operative times for RA-TKA are typically achieved between 15-20 cases.

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Area of Science:

  • Orthopedic Surgery
  • Medical Technology
  • Surgical Robotics

Background:

  • Robotic-assisted total knee arthroplasty (RA-TKA) offers improved accuracy and reduced complications.
  • Initial adoption of RA-TKA may lead to longer surgical times compared to manual techniques.

Purpose of the Study:

  • To analyze operative time trends and learning curves for robotic-assisted total knee arthroplasty.
  • To determine the proportion of surgeons achieving comparable operative times to manual total knee arthroplasty.
  • To identify the number of cases required to reach a steady-state operative time in RA-TKA.

Main Methods:

  • Utilized a hierarchical Bayesian model to analyze operative times from 146 surgeons across 30 hospitals (2016-2019).
  • Assessed operative time changes for surgeons performing at least 12 RA-TKA cases.
  • Modeled the learning curve and steady-state operative times based on case intervals.

Main Results:

  • 82% of surgeons demonstrated decreasing operative times within the first 12 RA-TKA cases.
  • 64% of surgeons achieved operative times comparable to manual total knee arthroplasty.
  • Steady-state operative times for RA-TKA were generally observed between 15 and 20 cases.

Conclusions:

  • A clear learning curve exists for robotic-assisted total knee arthroplasty.
  • Surgeons can achieve efficient operative times with experience, comparable to manual procedures.
  • The findings provide valuable insights into the adoption and efficiency of RA-TKA technology.