Learning curve for robotic-assisted total knee arthroplasty

Area of Science:

• Orthopaedic Surgery
• Robotics in Medicine
• Surgical Learning Curves

Background:

• The learning curve describes the improvement in task execution over time with increased practice.
• Competence in a surgical task should increase with frequency of performance.
• Understanding the learning curve is crucial for optimizing surgical training and patient outcomes.

Purpose of the Study:

• To investigate and characterize the learning curve associated with robotic-assisted total knee arthroplasty (TKA).
• To determine the relationship between the number of procedures performed and operative efficiency.
• To identify the point at which operative time stabilizes in robotic-assisted TKA.

Main Methods:

• Prospective screening of consecutive patients undergoing robotic-assisted TKA between 2021-2025.
• Procedures performed using a medial parapatellar approach and functional alignment strategy.
• Operative time recorded from skin incision to wound closure for 200 cases.

Main Results:

• The learning curve followed an exponential decay model, with initial rapid improvements followed by a plateau.
• Estimated asymptotic operative time was approximately 89.2 minutes, with a learning rate coefficient of 0.035.
• Statistically significant reductions in operative time were observed from the 41st to 50th procedure block, stabilizing around 90 minutes.

Conclusions:

• The most significant efficiency gains in robotic-assisted TKA occur early in the learning process.
• Operative times stabilize at approximately 90 minutes after around 40 procedures.
• These findings suggest a defined learning threshold for robotic-assisted TKA proficiency.