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Digital TKA Alignment Training with a New Digital Simulation Tool (Knee-CAT) Improves Process Quality, Efficiency,

Heiko Graichen1, Marco Strauch1, Michael T Hirschmann2

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Summary

A new digital simulator for total knee arthroplasty (TKA) training significantly improved surgeon decision-making accuracy and efficiency. This tool enhances learning of modern alignment philosophies in a stress-free environment.

Keywords:
alignmentcomputer assistanceroboticssimulatorteaching tooltotal knee arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Medical Simulation
  • Digital Health

Background:

  • Individualized alignment techniques are crucial for total knee arthroplasty (TKA) but transitioning to these methods using computer/robotic assistance presents challenges.
  • Educating surgeons on diverse modern alignment philosophies and their unique anatomical variations is essential for improving patient outcomes.

Purpose of the Study:

  • To develop and evaluate a digital training platform using real patient data for simulating various TKA alignment philosophies.
  • To assess the impact of the training tool on surgeon process quality, efficiency, and confidence in adopting new alignment techniques.

Main Methods:

  • Development of a web-based interactive TKA computer navigation simulator (Knee-CAT) using 1000 patient datasets.
  • Implementation of quantitative decision-making for bone cuts linked to gap values and 11 distinct alignment workflows.
  • Assessment of 40 surgeons' performance (process quality, efficiency) before and after two training courses on the platform.

Main Results:

  • Process quality, measured by correct decision percentage, significantly increased from 45% to 87.5% after training.
  • Surgical training efficiency improved, with time spent per exercise decreasing by 42% (from 4:28 to 2:35).
  • Surgeons reported high helpfulness ratings for the tool, valuing the stress-free learning environment and improved confidence in new alignment philosophies.

Conclusions:

  • A novel digital simulation tool (Knee-CAT) effectively facilitates case-based learning of TKA alignment philosophies.
  • The simulation platform, combined with training, enhances surgeon confidence, skill acquisition, and time efficiency in making correct alignment decisions.
  • This technology offers a valuable, stress-free method for surgeons to master advanced TKA alignment techniques outside the operating room.