Operative Time Learning Curve for an Image-Free Robotic Arm Assisted Total Knee Arthroplasty: A Cumulative Sum Analysis
Background: Robotic arm assisted total knee arthroplasty (RA-TKA) aims to improve accuracy in bone resection, implant positioning, and joint alignment compared to manual TKA (M-TKA). However, the learning curve of RA-TKA can disrupt operating room efficiency, increase complications, and raise costs....
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Elsevier
2025-02-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344124002735 |
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| author | Cale A. Pagan, MD Theofilos Karasavvidis, MD Breana Siljander, MD Eytan M. Debbi, MD, PhD Charles A. DeCook, MD Jonathan Vigdorchik, MD |
| author_facet | Cale A. Pagan, MD Theofilos Karasavvidis, MD Breana Siljander, MD Eytan M. Debbi, MD, PhD Charles A. DeCook, MD Jonathan Vigdorchik, MD |
| author_sort | Cale A. Pagan, MD |
| collection | DOAJ |
| description | Background: Robotic arm assisted total knee arthroplasty (RA-TKA) aims to improve accuracy in bone resection, implant positioning, and joint alignment compared to manual TKA (M-TKA). However, the learning curve of RA-TKA can disrupt operating room efficiency, increase complications, and raise costs. This study examines the operative time learning curve of RA-TKA using a single robotic system. Methods: The study analyzed the first 80 RA-TKA and the last 80 M-TKA cases performed by a single surgeon using the VELYS robotic system after transitioning from M-TKA. Cases were subdivided into groups of 20 and compared to M-TKA cases. A cumulative summation analysis identified the learning curve phases. Results: Three phases were identified: Phase 1 (initial learning, cases 1-9), Phase 2 (increased competence, plateau from cases 10-52), and Phase 3 (post-learning, optimized performance from cases 53-80). Mean surgical time for RA-TKA was 42.4 ± 8.7 minutes, compared to 35.3 ± 7.0 minutes for M-TKA (P < .001). Early RA-TKA cases (1-20) had significantly longer times than late RA-TKA cases (61-80) and M-TKA cases (P < .05). Late RA-TKA times were comparable to M-TKA (P = .06). Conclusions: RA-TKA is an enabling surgical tool that can be integrated efficiently into a surgical workflow with a rapid learning curve of 9 cases. |
| format | Article |
| id | doaj-art-6322a7bc8a1b497d889d51cd401eb0ac |
| institution | Kabale University |
| issn | 2352-3441 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj-art-6322a7bc8a1b497d889d51cd401eb0ac2025-02-10T04:34:27ZengElsevierArthroplasty Today2352-34412025-02-0131101588Operative Time Learning Curve for an Image-Free Robotic Arm Assisted Total Knee Arthroplasty: A Cumulative Sum AnalysisCale A. Pagan, MD0Theofilos Karasavvidis, MD1Breana Siljander, MD2Eytan M. Debbi, MD, PhD3Charles A. DeCook, MD4Jonathan Vigdorchik, MD5Adult Reconstruction and Joint Replacement Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA; Correspondence author. Department of Orthopaedic Surgery Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA. Tel.: +1 701 202 7238.Adult Reconstruction and Joint Replacement Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USAAdult Reconstruction and Joint Replacement Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USAAdult Reconstruction and Joint Replacement Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USAArthritis and Total Joint Specialists, Atlanta, GA, USAAdult Reconstruction and Joint Replacement Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USABackground: Robotic arm assisted total knee arthroplasty (RA-TKA) aims to improve accuracy in bone resection, implant positioning, and joint alignment compared to manual TKA (M-TKA). However, the learning curve of RA-TKA can disrupt operating room efficiency, increase complications, and raise costs. This study examines the operative time learning curve of RA-TKA using a single robotic system. Methods: The study analyzed the first 80 RA-TKA and the last 80 M-TKA cases performed by a single surgeon using the VELYS robotic system after transitioning from M-TKA. Cases were subdivided into groups of 20 and compared to M-TKA cases. A cumulative summation analysis identified the learning curve phases. Results: Three phases were identified: Phase 1 (initial learning, cases 1-9), Phase 2 (increased competence, plateau from cases 10-52), and Phase 3 (post-learning, optimized performance from cases 53-80). Mean surgical time for RA-TKA was 42.4 ± 8.7 minutes, compared to 35.3 ± 7.0 minutes for M-TKA (P < .001). Early RA-TKA cases (1-20) had significantly longer times than late RA-TKA cases (61-80) and M-TKA cases (P < .05). Late RA-TKA times were comparable to M-TKA (P = .06). Conclusions: RA-TKA is an enabling surgical tool that can be integrated efficiently into a surgical workflow with a rapid learning curve of 9 cases.http://www.sciencedirect.com/science/article/pii/S2352344124002735RoboticTechnologyEfficiencyTotal knee arthroplastyLearning curve |
| spellingShingle | Cale A. Pagan, MD Theofilos Karasavvidis, MD Breana Siljander, MD Eytan M. Debbi, MD, PhD Charles A. DeCook, MD Jonathan Vigdorchik, MD Operative Time Learning Curve for an Image-Free Robotic Arm Assisted Total Knee Arthroplasty: A Cumulative Sum Analysis Arthroplasty Today Robotic Technology Efficiency Total knee arthroplasty Learning curve |
| title | Operative Time Learning Curve for an Image-Free Robotic Arm Assisted Total Knee Arthroplasty: A Cumulative Sum Analysis |
| title_full | Operative Time Learning Curve for an Image-Free Robotic Arm Assisted Total Knee Arthroplasty: A Cumulative Sum Analysis |
| title_fullStr | Operative Time Learning Curve for an Image-Free Robotic Arm Assisted Total Knee Arthroplasty: A Cumulative Sum Analysis |
| title_full_unstemmed | Operative Time Learning Curve for an Image-Free Robotic Arm Assisted Total Knee Arthroplasty: A Cumulative Sum Analysis |
| title_short | Operative Time Learning Curve for an Image-Free Robotic Arm Assisted Total Knee Arthroplasty: A Cumulative Sum Analysis |
| title_sort | operative time learning curve for an image free robotic arm assisted total knee arthroplasty a cumulative sum analysis |
| topic | Robotic Technology Efficiency Total knee arthroplasty Learning curve |
| url | http://www.sciencedirect.com/science/article/pii/S2352344124002735 |
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