Introduction of ROSA robotic‐arm system for total knee arthroplasty is associated with a minimal learning curve for operative time
Abstract Purpose The introduction of robotics for total knee arthroplasty (TKA) into the operating theatre is often associated with a learning curve and is potentially associated with additional complications. The purpose of this study was to determine the learning curve of robotic‐assisted (RA) TKA...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Journal of Experimental Orthopaedics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40634-022-00524-5 |
| _version_ | 1797321474612133888 |
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| author | Scott M. Bolam Mei Lin Tay Faseeh Zaidi Raghavendra P. Sidaginamale Michael Hanlon Jacob T. Munro A. Paul Monk |
| author_facet | Scott M. Bolam Mei Lin Tay Faseeh Zaidi Raghavendra P. Sidaginamale Michael Hanlon Jacob T. Munro A. Paul Monk |
| author_sort | Scott M. Bolam |
| collection | DOAJ |
| description | Abstract Purpose The introduction of robotics for total knee arthroplasty (TKA) into the operating theatre is often associated with a learning curve and is potentially associated with additional complications. The purpose of this study was to determine the learning curve of robotic‐assisted (RA) TKA within a multi‐surgeon team. Methods This prospective cohort study included 83 consecutive conventional jig‐based TKAs compared with 53 RA TKAs using the Robotic Surgical Assistant (ROSA) system (Zimmer Biomet, Warsaw, Indiana, USA) for knee osteoarthritis performed by three high‐volume (> 100 TKA per year) orthopaedic surgeons. Baseline characteristics including age, BMI, sex and pre‐operative Kellgren‐Lawrence graded and Hip‐Knee‐Ankle Axis were well‐matched between the conventional and RA TKA groups. Cumulative summation (CUSUM) analysis was used to assess learning curves for operative times for each surgeon. Peri‐operative and delayed complications (infection, periprosthetic fracture, thromboembolism, and compromised wound healing) and revisions were reviewed. Results The CUSUM analysis for operative time demonstrated an inflexion point after 5, 6 and 15 cases for each of the three surgeons, or 8.7 cases on average. There were no significant differences (p = 0.53) in operative times between the RA TKA learning (before inflexion point) and proficiency (after inflexion point) phases. Similarly, the operative times of the RA TKA group did not differ significantly (p = 0.92) from the conventional TKA group. There was no discernible learning curve for the accuracy of component planning using the RA TKA system. The average length of post‐operative follow‐up was 21.3 ± 9.0 months. There was one revision for instability in the conventional TKA group and none in the RA TKA group. There were no significant difference (p > 0.99) in post‐operative complication rates between the conventional TKA and RA TKA groups. Conclusions The introduction of the RA TKA system was associated with a learning curve for operative time of 8.7 cases. Operative times between the RA TKA and conventional TKA group were similar. The short learning curve implies this RA TKA system can be adopted relatively quickly into a surgical team with minimal risks to patients. |
| first_indexed | 2024-03-08T04:58:06Z |
| format | Article |
| id | doaj.art-0b3c4fa9dfe64f718095350307310953 |
| institution | Directory Open Access Journal |
| issn | 2197-1153 |
| language | English |
| last_indexed | 2024-03-08T04:58:06Z |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Experimental Orthopaedics |
| spelling | doaj.art-0b3c4fa9dfe64f7180953503073109532024-02-07T14:50:37ZengWileyJournal of Experimental Orthopaedics2197-11532022-01-0191n/an/a10.1186/s40634-022-00524-5Introduction of ROSA robotic‐arm system for total knee arthroplasty is associated with a minimal learning curve for operative timeScott M. Bolam0Mei Lin Tay1Faseeh Zaidi2Raghavendra P. Sidaginamale3Michael Hanlon4Jacob T. Munro5A. Paul Monk6Department of Orthopaedic SurgeryAuckland City HospitalAucklandNew ZealandDepartment of SurgeryFaculty of Medical and Health SciencesUniversity of AucklandBuilding 502 20185 Park Road, Grafton1023AucklandNew ZealandDepartment of SurgeryFaculty of Medical and Health SciencesUniversity of AucklandBuilding 502 20185 Park Road, Grafton1023AucklandNew ZealandDepartment of OrthopaedicsUniversity Hospital of North TeesStockton on TeesUnited KingdomDepartment of Orthopaedic SurgeryAuckland City HospitalAucklandNew ZealandDepartment of Orthopaedic SurgeryAuckland City HospitalAucklandNew ZealandDepartment of Orthopaedic SurgeryAuckland City HospitalAucklandNew ZealandAbstract Purpose The introduction of robotics for total knee arthroplasty (TKA) into the operating theatre is often associated with a learning curve and is potentially associated with additional complications. The purpose of this study was to determine the learning curve of robotic‐assisted (RA) TKA within a multi‐surgeon team. Methods This prospective cohort study included 83 consecutive conventional jig‐based TKAs compared with 53 RA TKAs using the Robotic Surgical Assistant (ROSA) system (Zimmer Biomet, Warsaw, Indiana, USA) for knee osteoarthritis performed by three high‐volume (> 100 TKA per year) orthopaedic surgeons. Baseline characteristics including age, BMI, sex and pre‐operative Kellgren‐Lawrence graded and Hip‐Knee‐Ankle Axis were well‐matched between the conventional and RA TKA groups. Cumulative summation (CUSUM) analysis was used to assess learning curves for operative times for each surgeon. Peri‐operative and delayed complications (infection, periprosthetic fracture, thromboembolism, and compromised wound healing) and revisions were reviewed. Results The CUSUM analysis for operative time demonstrated an inflexion point after 5, 6 and 15 cases for each of the three surgeons, or 8.7 cases on average. There were no significant differences (p = 0.53) in operative times between the RA TKA learning (before inflexion point) and proficiency (after inflexion point) phases. Similarly, the operative times of the RA TKA group did not differ significantly (p = 0.92) from the conventional TKA group. There was no discernible learning curve for the accuracy of component planning using the RA TKA system. The average length of post‐operative follow‐up was 21.3 ± 9.0 months. There was one revision for instability in the conventional TKA group and none in the RA TKA group. There were no significant difference (p > 0.99) in post‐operative complication rates between the conventional TKA and RA TKA groups. Conclusions The introduction of the RA TKA system was associated with a learning curve for operative time of 8.7 cases. Operative times between the RA TKA and conventional TKA group were similar. The short learning curve implies this RA TKA system can be adopted relatively quickly into a surgical team with minimal risks to patients.https://doi.org/10.1186/s40634-022-00524-5Learning curveOperative timeRobotically assisted systemPersonalised robotic TKAROSA knee system |
| spellingShingle | Scott M. Bolam Mei Lin Tay Faseeh Zaidi Raghavendra P. Sidaginamale Michael Hanlon Jacob T. Munro A. Paul Monk Introduction of ROSA robotic‐arm system for total knee arthroplasty is associated with a minimal learning curve for operative time Journal of Experimental Orthopaedics Learning curve Operative time Robotically assisted system Personalised robotic TKA ROSA knee system |
| title | Introduction of ROSA robotic‐arm system for total knee arthroplasty is associated with a minimal learning curve for operative time |
| title_full | Introduction of ROSA robotic‐arm system for total knee arthroplasty is associated with a minimal learning curve for operative time |
| title_fullStr | Introduction of ROSA robotic‐arm system for total knee arthroplasty is associated with a minimal learning curve for operative time |
| title_full_unstemmed | Introduction of ROSA robotic‐arm system for total knee arthroplasty is associated with a minimal learning curve for operative time |
| title_short | Introduction of ROSA robotic‐arm system for total knee arthroplasty is associated with a minimal learning curve for operative time |
| title_sort | introduction of rosa robotic arm system for total knee arthroplasty is associated with a minimal learning curve for operative time |
| topic | Learning curve Operative time Robotically assisted system Personalised robotic TKA ROSA knee system |
| url | https://doi.org/10.1186/s40634-022-00524-5 |
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