Robotic-arm assisted total knee arthroplasty has a learning curve of seven cases for integration into the surgical workflow but no learning curve effect for accuracy of implant positioning

Purpose The primary objective of this study was to determine the surgical team’s learning curve for robotic-arm assisted TKA through assessments of operative times, surgical team comfort levels, accuracy of implant positioning, limb alignment, and postoperative complications. Secondary objectives we...

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Bibliographic Details
Published in:Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2019-04, Vol.27 (4), p.1132-1141
Main Authors: Kayani, Babar, Konan, S., Huq, S. S., Tahmassebi, J., Haddad, F. S.
Format: Article
Language:English
Subjects:
Accuracy
Alignment
Anxiety
Arm
Arthroplasty (knee)
Biomedical materials
Complications
Health care
Integration
Jigs
Joint surgery
Knee
Learning
Learning curves
Medical personnel
Medicine
Medicine & Public Health
Orthopedics
Restoration
Robotic surgery
Robotics
Surgical implants
Transplants & implants
Workflow
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Summary:Purpose The primary objective of this study was to determine the surgical team’s learning curve for robotic-arm assisted TKA through assessments of operative times, surgical team comfort levels, accuracy of implant positioning, limb alignment, and postoperative complications. Secondary objectives were to compare accuracy of implant positioning and limb alignment in conventional jig-based TKA versus robotic-arm assisted TKA. Methods This prospective cohort study included 60 consecutive conventional jig-based TKAs followed by 60 consecutive robotic-arm assisted TKAs performed by a single surgeon. Independent observers recorded surrogate markers of the learning curve including operative times, stress levels amongst the surgical team using the state-trait anxiety inventory (STAI) questionnaire, accuracy of implant positioning, limb alignment, and complications within 30 days of surgery. Cumulative summation (CUSUM) analyses were used to assess learning curves for operative time and STAI scores in robotic TKA. Results Robotic-arm assisted TKA was associated with a learning curve of seven cases for operative times ( p  = 0.01) and surgical team anxiety levels ( p  = 0.02). Cumulative robotic experience did not affect accuracy of implant positioning (n.s.) limb alignment (n.s.) posterior condylar offset ratio (n.s.) posterior tibial slope (n.s.) and joint line restoration (n.s.). Robotic TKA improved accuracy of implant positioning ( p  
ISSN:0942-2056
1433-7347
DOI:10.1007/s00167-018-5138-5