Early Learning Curve in Robotic-Assisted Total Knee Arthroplasty: A Single-Center Experience

Area of Science:

• Orthopedic Surgery
• Robotic Surgery
• Surgical Education

Background:

• Robotic-assisted total knee arthroplasty (RA TKA) offers potential benefits but involves a learning curve.
• Understanding this learning curve is crucial for surgeon training and efficient adoption of robotic systems.

Purpose of the Study:

• To evaluate the learning curve for RA TKA in experienced surgeons.
• To assess changes in procedure duration, surgeon satisfaction, and confidence during the initial learning phase.

Main Methods:

• Prospective study involving three senior arthroplasty surgeons performing 15 RA TKA procedures each.
• Data collected included operative times (preparation, cut-to-suture, breakdown) and surgeon-reported anxiety, satisfaction, and confidence.
• Preoperative anxiety measured using STAI-6; postoperative assessments via questionnaire.

Main Results:

• Significant reductions in robotic-specific steps (up to 30%) and general instrument preparation (20%) were observed between the first and last five procedures (p < 0.001 to p = 0.025).
• Average cut-to-suture time was 1 hour 38 minutes.
• Surgeon anxiety decreased, while postoperative satisfaction and confidence increased by the 15th procedure.

Conclusions:

• A substantial learning curve exists for RA TKA, with demonstrated improvements in efficiency and surgeon confidence by the 15th case.
• Findings support the potential for optimized workflows and provide guidance for training new robotic knee arthroplasty surgeons.