Does Resident Rotation Affect the Learning Curve of Active Robotic TKA? A Study of Surgical Efficiency and...

Area of Science:

• Orthopedic Surgery
• Robotics in Medicine

Background:

• Learning curves for semi-active robotic systems in total knee arthroplasty (TKA) are known.
• Data on learning curves for advanced fully active robotic TKA systems is limited.

Purpose of the Study:

• To define the learning curve for operative time, implant positioning, and lower-limb alignment using a fully active robotic TKA system.
• To assess the influence of resident rotations on the learning curve in a tertiary care setting.

Main Methods:

• Sixty primary TKAs were performed using the CUVIS-Joint® advanced active robotic system.
• Cumulative summation (CUSUM) analysis evaluated the operative time learning curve.
• Multivariate linear regression identified predictors of surgical duration and radiographic precision.

Main Results:

• A significant learning curve inflection point for operative time was observed at the 39th case (p < 0.001).
• Mean operative time decreased by approximately 20 minutes after the 39th case.
• Case number was the only independent predictor of operative time; implant positioning and alignment remained consistently precise (p > 0.05).

Conclusions:

• The learning curve for operative time in active robotic TKA stabilizes after 39 cases, even with resident involvement.
• Radiographic accuracy is maintained consistently throughout the learning process.
• The advanced active robotic system is technically feasible and reliable for treating end-stage knee osteoarthritis.