Initial learning curve of lateral unicompartmental knee arthroplasty

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee Pub Date : 2025-05-21 DOI:10.1016/j.knee.2025.05.013

Weibo Zheng , Houyi Sun , Binglong Li , Ziyue Chu , Dehua Liu , Shihao Li , Yange Luo , Songlin Li , Baoqing Zhang , Qunshan Lu , Peilai Liu

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引用次数: 0

Abstract

This study obtained the learning curve of a chief surgeon’s lateral unicompartmental knee arthroplasty surgery using the cumulative summation analysis (CUSUM) method and divided the curve into two stages: the learning stage and the proficient stage. The inflection point of the learning curve is around the 11th case. The surgical time and team anxiety were relieved in the proficient stage. The study also summarized some possible methods for shortening the learning curve.

Purpose

To describe the initial learning curve of lateral unicompartmental knee arthroplasty (LUKA), compare its effectiveness at different stages, optimize its learning curve, reduce surgical risks, and provide experience and theoretical guidance for clinical practice.

Methods

A retrospective analysis was conducted on the relevant data of the initial 30 patients who underwent LUKA performed by a single primary surgeon from August 2018 to September 2022. Cumulative summation analysis (CUSUM) was utilized to analyse the surgical time of 30 consecutive surgeries and plot the learning curve. The learning curve was divided into two stages: the learning stage and the proficient stage. The perioperative parameters, including the state-trait anxiety inventory (STAI), surgical time, pre- and postoperative haemoglobin levels, length of hospital stay, and surgical incision length, were recorded. Postoperative imaging indicators, which reflect the placement position of the prosthesis, and functional follow-up results between these two stages were explored and analysed.

Results

The CUSUM showed that the learning curve reached a maximum at the 11th case and then decreased gradually; hence, patients 1–11 represented the learning stage, and patients 12–30 represented the proficient stage. All patients were followed up at 6-month, 1-year and 2-year after surgery. During the follow-up period, none of the patients experienced complications such as implant loosening, periprosthetic fracture, dislocation of the bearing insert, or periprosthetic infection. There were no statistically significant differences (P > 0.05) observed between the learning stage and proficient stage for any of the observed parameters, except for surgical time.

Conclusions

The operation time-related learning curve for LUKA patients was 11, but surgery did not affect postoperative imaging or functional outcomes at early follow-up.

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外侧单室膝关节置换术的初始学习曲线

本研究采用累积求和分析法（cumulative sum analysis， CUSUM）获得了一名主任医师外侧单室膝关节置换术的学习曲线，并将曲线分为学习阶段和熟练阶段。学习曲线的拐点在第11个案例左右。熟练阶段手术时间和团队焦虑得到缓解。研究还总结了一些缩短学习曲线的可能方法。目的描述外侧单室膝关节置换术（LUKA）的初始学习曲线，比较其在不同阶段的疗效，优化其学习曲线，降低手术风险，为临床实践提供经验和理论指导。方法回顾性分析2018年8月至2022年9月30例由单一主刀医师行LUKA的患者的相关资料。采用累积求和分析法（CUSUM）对30例连续手术的手术时间进行分析，绘制学习曲线。学习曲线分为两个阶段：学习阶段和熟练阶段。记录围手术期参数，包括状态-特质焦虑量表（STAI）、手术时间、术前和术后血红蛋白水平、住院时间和手术切口长度。探讨并分析反映假体放置位置的术后影像学指标以及两阶段的功能随访结果。结果CUSUM显示，学习曲线在第11例时达到最大值，然后逐渐下降；因此，患者1-11代表学习阶段，患者12-30代表熟练阶段。所有患者均于术后6个月、1年和2年随访。在随访期间，所有患者均未出现假体松动、假体周围骨折、假体植入物脱位或假体周围感染等并发症。差异无统计学意义(P >；除手术时间外，其他观察参数在学习期和熟练期之间的差异均为0.05)。结论LUKA患者的手术时间相关学习曲线为11，但手术对早期随访的术后影像学和功能结局没有影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.