Introduction of ROSA robotic-arm system for total knee arthroplasty is associated with a minimal learning curve for operative time.

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dc.contributor.author Bolam, Scott M
dc.contributor.author Tay, Mei Lin
dc.contributor.author Zaidi, Faseeh
dc.contributor.author Sidaginamale, Raghavendra P
dc.contributor.author Hanlon, Michael
dc.contributor.author Munro, Jacob T
dc.contributor.author Monk, A Paul
dc.coverage.spatial Germany
dc.date.accessioned 2022-10-19T23:26:13Z
dc.date.available 2022-10-19T23:26:13Z
dc.date.issued 2022-12
dc.identifier.citation (2022). Journal of experimental orthopaedics, 9(1), 86-.
dc.identifier.issn 2197-1153
dc.identifier.uri https://hdl.handle.net/2292/61632
dc.description.abstract <h4>Purpose</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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.
dc.format.medium Print-Electronic
dc.language eng
dc.publisher Springer Nature
dc.relation.ispartofseries Journal of experimental orthopaedics
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher.
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm
dc.rights.uri https://creativecommons.org/licenses/by/4.0/
dc.subject Learning curve
dc.subject Operative time
dc.subject Personalised robotic TKA
dc.subject ROSA knee system
dc.subject Robotically assisted system
dc.subject Arthritis
dc.subject 6 Evaluation of treatments and therapeutic interventions
dc.subject 6.4 Surgery
dc.subject Musculoskeletal
dc.title Introduction of ROSA robotic-arm system for total knee arthroplasty is associated with a minimal learning curve for operative time.
dc.type Journal Article
dc.identifier.doi 10.1186/s40634-022-00524-5
pubs.issue 1
pubs.begin-page 86
pubs.volume 9
dc.date.updated 2022-09-25T21:35:57Z
dc.rights.holder Copyright: The authors en
dc.identifier.pmid 36042122 (pubmed)
pubs.author-url https://www.ncbi.nlm.nih.gov/pubmed/36042122
pubs.publication-status Accepted
dc.rights.accessrights http://purl.org/eprint/accessRights/OpenAccess en
pubs.subtype research-article
pubs.subtype Journal Article
pubs.elements-id 917741
pubs.org-id Bioengineering Institute
pubs.org-id Medical and Health Sciences
pubs.org-id School of Medicine
pubs.org-id Surgery Department
dc.identifier.eissn 2197-1153
dc.identifier.pii 10.1186/s40634-022-00524-5
pubs.number 86
pubs.record-created-at-source-date 2022-09-26
pubs.online-publication-date 2022-08-30


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