Robotic Guided Knee Arthroplasty - Group Learning Curve and Early Outcomes

Area of Science:

• Orthopaedic Surgery
• Robotic Surgery
• Surgical Education

Background:

• Surgeons experience learning curves for robotic-assisted total knee arthroplasty (raTKA).
• Understanding the number of cases needed for proficiency is crucial for adoption.
• Previous studies focused on individual surgeon learning curves.

Purpose of the Study:

• To determine the number of raTKA cases required to achieve proficiency in operative time (OT) among a group of surgeons.
• To assess the impact of surgical experience on raTKA efficiency.
• To compare raTKA learning curves across multiple surgeons.

Main Methods:

• Retrospective analysis comparing raTKA with manual total knee arthroplasty (mTKA).
• Data from 6 surgeons and 90 raTKA cases, divided into three groups of 30.
• Operative time (tourniquet time) and range of motion (ROM) were primary outcome measures.

Main Results:

• Average operative time (OT) was significantly longer for raTKA compared to mTKA.
• OT significantly decreased with successive groups of 30 raTKA cases (97.6, 86.6, 76.7 min).
• No significant difference in 6-week postoperative ROM or complication rates was observed between groups.

Conclusions:

• A group learning curve for raTKA was demonstrated, with decreasing OT over time.
• Proficiency in raTKA, indicated by reduced OT, is achievable with increasing case volume.
• Initial adoption of raTKA is associated with longer operative times, but efficiency improves.
• Robotic-assisted surgery shows no increased complication rates compared to manual techniques.