Related Experiment Video
Updated: May 1, 2026
A Teleoperated Robotic System-Assisted Percutaneous Transiliac-Transsacral Screw Fixation Technique
Published on: January 6, 2023
The Impact of Enabling Technology on Surgeon Workload in Total Knee Arthroplasty: A National Survey Comparing Manual
Drake G LeBrun1, Corey F Hryc1, James I Huddleston2
1Fondren Orthopedic Research Institute, Fondren Orthopedic Group, Houston, Texas.
Background:
Robotic and computer-assisted technologies in total knee arthroplasty (TKA) have grown rapidly, yet their effect on surgeon workload remains unclear. While enabling technologies may reduce physical strain, they may also increase cognitive and organizational demands. This study evaluated surgeon-perceived workload in manual versus technology-enabled TKA using a validated surgical workload assessment instrument.
Methods:
A cross-sectional, survey-based study was distributed to members of the American Association of Hip and Knee Surgeons. Respondents provided demographic and practice information and completed a survey for both manual and technology-enabled TKA performed in the past three years. After exclusions for incomplete or invalid data, 374 surveys were analyzed, including 248 with paired responses. Outcomes included domain-specific and overall workload assessment scores, with subgroup analyses by years in practice, case volume, practice setting, surgical site, and platform type.
Results:
Technology-enabled TKA was associated with higher task complexity (45.6 ± 26.6 versus 38.7 ± 24.9, P < 0.001) and distraction scores (30.7 ± 25.4 versus 23.7 ± 20.5, P < 0.001) but lower physical demand (44.6 ± 23.0 versus 48.9 ± 22.2, P < 0.001). There were no significant differences observed in mental or temporal demand or situational stress. Composite scores were similar between technology-enabled procedures and manual procedures (40.3 ± 20.8 versus 38.1 ± 19.6, P = 0.11). Subgroup analyses revealed greater workload with technology among low adopters and imageless platform users, while high adopters reported reduced workload.
Conclusions:
Technology-enabled TKA shifts surgeon workload by increasing task complexity and distractions while reducing physical demands. Effects vary by experience, setting, and platform, underscoring the need for structured integration and support when adopting new technologies.
