Short learning curve associated with robotic total knee arthroplasty: A retrospective study

IF 2.7 Q2 ORTHOPEDICS
Alexandre Le Guen, Antoine Mouton, Guillaume Auberger, Vincent Le Strat, Simon Marmor, Thomas Aubert
{"title":"Short learning curve associated with robotic total knee arthroplasty: A retrospective study","authors":"Alexandre Le Guen,&nbsp;Antoine Mouton,&nbsp;Guillaume Auberger,&nbsp;Vincent Le Strat,&nbsp;Simon Marmor,&nbsp;Thomas Aubert","doi":"10.1002/jeo2.70401","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>Robotic-assisted total knee arthroplasty (RA-TKA), which is increasingly used to improve surgical precision, can face adoption difficulties due to a learning curve marked by longer operating times. The aim of this study was to evaluate the learning curve associated with the VELYS™ robot in five surgeons from the same centre with different annual arthroplasty volumes using navigated assistance with personalised alignment. The primary aim was to assess the learning curve for each surgeon. Secondary aims were to identify the factors associated with extended operative times.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>In this retrospective comparative study, 367 patients who underwent primary TKA between January and December 2024 were included, comprising 149 with robotic assistance and 218 with navigated assistance. The surgical learning curve, based on skin-to-skin operating time, was assessed using the cumulative summation method. Five surgeons were evaluated: two high-volume surgeons (&gt;150 TKAs per year), a medium-volume surgeon (between 50 and 150) and two low-volume surgeons (&lt;50). Pre- and intra-operative data (age, gender, body mass index, American Society of Anesthesiologists score, pre-operative hip–knee–ankle, range of motion, approach, size and implant constraint and type of assistance) were collected to identify extended operative time factors.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The learning curve was reached after performing between 4 and 11 cases (11 procedures for surgeon no. 1, 4 for surgeon no. 2, 6 for surgeon no. 3, 4 for surgeon no. 4 and 4 for surgeon no. 5). The robotic operating time was 57.1 min compared to 54.1 min (<i>p</i> = 0.017) with navigation. The increase was statistically significant only for one low-volume surgeon (<i>p</i> = 0.008). Use of the robot (<i>p</i> &lt; 0.001), surgeon (<i>p</i> &lt; 0.001), use of a posterior-stabilised implant (<i>p</i> &lt; 0.001) and varus of more than 10° (<i>p</i> = 0.0191) were independent factors associated with extended operative time.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>The learning curve associated with VELYS™ was between 4 and 11 procedures. The small increase in operative time compared to navigation should not be a barrier to its adoption.</p>\n </section>\n \n <section>\n \n <h3> Level of Evidence</h3>\n \n <p>Level III, case–control retrospective analysis.</p>\n </section>\n </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://esskajournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70401","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Experimental Orthopaedics","FirstCategoryId":"1085","ListUrlMain":"https://esskajournals.onlinelibrary.wiley.com/doi/10.1002/jeo2.70401","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose

Robotic-assisted total knee arthroplasty (RA-TKA), which is increasingly used to improve surgical precision, can face adoption difficulties due to a learning curve marked by longer operating times. The aim of this study was to evaluate the learning curve associated with the VELYS™ robot in five surgeons from the same centre with different annual arthroplasty volumes using navigated assistance with personalised alignment. The primary aim was to assess the learning curve for each surgeon. Secondary aims were to identify the factors associated with extended operative times.

Methods

In this retrospective comparative study, 367 patients who underwent primary TKA between January and December 2024 were included, comprising 149 with robotic assistance and 218 with navigated assistance. The surgical learning curve, based on skin-to-skin operating time, was assessed using the cumulative summation method. Five surgeons were evaluated: two high-volume surgeons (>150 TKAs per year), a medium-volume surgeon (between 50 and 150) and two low-volume surgeons (<50). Pre- and intra-operative data (age, gender, body mass index, American Society of Anesthesiologists score, pre-operative hip–knee–ankle, range of motion, approach, size and implant constraint and type of assistance) were collected to identify extended operative time factors.

Results

The learning curve was reached after performing between 4 and 11 cases (11 procedures for surgeon no. 1, 4 for surgeon no. 2, 6 for surgeon no. 3, 4 for surgeon no. 4 and 4 for surgeon no. 5). The robotic operating time was 57.1 min compared to 54.1 min (p = 0.017) with navigation. The increase was statistically significant only for one low-volume surgeon (p = 0.008). Use of the robot (p < 0.001), surgeon (p < 0.001), use of a posterior-stabilised implant (p < 0.001) and varus of more than 10° (p = 0.0191) were independent factors associated with extended operative time.

Conclusion

The learning curve associated with VELYS™ was between 4 and 11 procedures. The small increase in operative time compared to navigation should not be a barrier to its adoption.

Level of Evidence

Level III, case–control retrospective analysis.

Abstract Image

Abstract Image

Abstract Image

Abstract Image

与机器人全膝关节置换术相关的短学习曲线:一项回顾性研究
机器人辅助全膝关节置换术(RA-TKA)越来越多地用于提高手术精度,但由于其学习曲线以较长的操作时间为标志,因此可能面临采用困难。本研究的目的是评估来自同一中心的五名外科医生使用VELYS™机器人的学习曲线,这些外科医生每年使用不同的关节置换术容积,使用导航辅助和个性化对齐。主要目的是评估每位外科医生的学习曲线。次要目的是确定与延长手术时间相关的因素。方法在这项回顾性比较研究中,纳入了367例于2024年1月至12月期间接受原发性TKA的患者,其中149例采用机器人辅助,218例采用导航辅助。基于皮肤对皮肤手术时间的手术学习曲线,采用累积求和法进行评估。5名外科医生被评估:2名高容量外科医生(每年150 tka), 1名中等容量外科医生(50 - 150)和2名低容量外科医生(50 tka)。收集术前和术中数据(年龄、性别、体重指数、美国麻醉医师协会评分、术前髋关节-膝关节-踝关节、活动范围、入路、大小和植入物约束以及辅助类型)以确定延长手术时间的因素。结果4 ~ 11例(其中11例为第11号外科医生)术后均达到学习曲线。1、4号外科医生。2、6号外科医生。3、4号外科医生。4号和4号为外科医生。5)。机器人操作时间为57.1 min,导航操作时间为54.1 min (p = 0.017)。只有一名小容量外科医生的增加有统计学意义(p = 0.008)。使用机器人(p < 0.001)、外科医生(p < 0.001)、使用后稳定植入物(p < 0.001)和内翻超过10°(p = 0.0191)是延长手术时间的独立因素。结论与VELYS™相关的学习曲线在4到11次手术之间。与导航相比,操作时间的小幅增加不应成为采用它的障碍。证据等级III级,病例对照回顾性分析。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Journal of Experimental Orthopaedics
Journal of Experimental Orthopaedics Medicine-Orthopedics and Sports Medicine
CiteScore
3.20
自引率
5.60%
发文量
114
审稿时长
13 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信