Improved Efficiency and Intraoperative Planning With 1 Robot-Assisted Total Knee Arthroplasty System

Area of Science:

• Orthopedic Surgery
• Robotics in Medicine
• Surgical Education

Background:

• Robotic-assisted total knee arthroplasty (rTKA) offers potential for enhanced surgical precision.
• Concerns exist regarding longer operative times and learning curves with robotic systems.
• Evaluating the learning curve of specific robotic platforms is crucial for adoption.

Purpose of the Study:

• To assess the learning curve associated with the Robotic Surgical Assistant (ROSA) system for total knee arthroplasty.
• To quantify changes in operative time components during the initial adoption of ROSA rTKA.
• To identify specific procedural elements that contribute to efficiency gains.

Main Methods:

• Retrospective review of the first 75 ROSA rTKA procedures per surgeon (2 surgeons, 150 total cases).
• Analysis of time stamps from robotic software and tourniquet times.
• Statistical analysis including t-tests and multilevel regression.

Main Results:

• Significant reductions observed in tourniquet time (61.4 to 56.7 min) and planning time (13.49 to 6.68 min) between early and late cases.
• Landmark identification times for femur and tibia remained stable.
• Regression analysis confirmed significant decreases in tourniquet and planning times with experience.

Conclusions:

• The ROSA system for rTKA demonstrates increased efficiency within the first 75 cases.
• The most significant improvement with experience is in the cognitive planning phase.
• Findings suggest technical aspects are quickly learned, guiding industry focus towards optimizing the planning panel.