[Learning curve analysis of robot-assisted percutaneous placmemt of acetabular anterior column screws]

To analyze the learning curve of robot-assisted percutaneous placement of acetabular anterior column screws.

Between January 2021 and January 2024, 30 patients undergoing robot-assisted percutaneous acetabular anterior column screw placement performed by the same surgeon were enrolled, including 21 males and 9 females, aged from 27 to 65 years old with a mean of (45.2±17.6) years old, with a disease course ranging from 1 to 9 days with a mean of (1.1±5.3) days. According to the chronological order of surgery, the patients were divided into an early group, a middle group, and a late group, with 10 cases in each group. The number of screws graded as excellent, good, and poor was recorded in each group. Fluoroscopy times, screw planning time, guide wire adjustment times, and total operation time were compared among groups. The learning curve was analyzed using curve regression.

All procedures was successfully completed in all three groups, without intraoperative or postoperative complications. Postoperative coronal CT showed that in the early group, excellent/good screws were 8/2;in the middle group, excellent/good screws were 9/1;in the late group, excellent/good screws were 9/1. All screws were graded as excellent or good (26/4), without cortical perforation or poor grade screws. There was no significant difference in the proportion of excellent and good screws among the three groups (P>0.05). Fluoroscopy times, screw planning time, guide wire adjustment times, and total operation time:the differences were statistically significant between the early group and the middle group, and between the early group and the late group (P<0.05), while no significant difference was found between the middle group and the late group(P>0.05). Curve regression showed that fluoroscopy times, screw planning time, guide wire adjustment times, and total operation time for robot-assisted percutaneous antegrade anterior column screw placement gradually decreased progressively with increasing surgical experience and reached a plateau after approximately 15 cases.

The learning curve of robot-assisted percutaneous acetabular anterior column screw placement is relatively steep, and surgical performance tends to stabilize after about 15 cases.