Abstract
As with most new surgical technologies, there is an associated learning curve with
robotic-assisted total knee arthroplasty (TKA) before surgeons can expect ease of
use to be similar to that of manual cases. Therefore, the purpose of this study was
to (1) assess robotic-assisted versus manual operative times of two joint reconstructive
surgeons separately as well as (2) find an overall learning curve. A total of 240
robotic-assisted TKAs performed by two board-certified surgeons were analyzed. The
cases were sequentially grouped into 20 cases and a learning curve was created based
on mean operative times. For each surgeon, mean operative times for their first 20
and last 20 robotic-assisted cases were compared with 20 randomly selected manual
cases performed by that surgeon as controls prior to the initiation of the robotic-assisted
cases. Each of the surgeons first 20 robotic assisted, last 20 robotic assisted, and
20 controls were then combined to create 3 cohorts of 40 cases for analysis. Surgeon 1: First and last robotic cohort operative times were 81 and 70 minutes (p < 0.05). Mean operative times for the first 20 robotic-assisted cases and manual
cases were 81 versus 68 minutes (p < 0.05). Mean operative times for the last 20 robotic-assisted cases and manual cases
were 70 versus 68 minutes (p > 0.05). Surgeon 2: First and last robotic cohort operative times were 117 and 98 minutes (p < 0.05). Mean operative times for the first 20 robotic-assisted cases and manual
cases were 117 versus 95 (p < 0.05). Mean operative times for the last 20 robotic-cohort cases and manual cases
were 98 versus 95 (p > 0.05). A similar trend occurred when the times of two surgeons were combined. The
data from this study effectively create a learning curve for the use of robotic-assisted
TKA. As both surgeons completed their total cases numbers within similar time frames,
these data imply that within a few months, a board-certified orthopaedic joint arthroplasty
surgeon should be able to adequately perform robotic TKA without adding any operative
times.
Keywords
robotic-assisted total knee arthroplasty - total knee arthroplasty - learning curve
