Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Ring Road Efkarpia, 56403, Thessaloniki, Greece.
Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Buildings A & B, Thessaloniki, 10th km Thessaloniki-Thermi Rd, P.O. Box 8318, 57001, Thessaloniki, Greece.
Eur J Orthop Surg Traumatol. 2023 Dec;33(8):3357-3363. doi: 10.1007/s00590-023-03554-6. Epub 2023 Apr 27.
PURPOSE: Limited published data regarding the ROSA (Robotic Surgical Assistant) learning curve exist. This study evaluated the number of cases needed for an expert orthopaedic surgeon to master the ROSA system and match the operative time of robotic (raTKAs) and manual primary total knee arthroplasties (mTKAs). METHODS: This retrospective comparative cohort study included two hundred patients with primary knee osteoarthritis. The study group consisted of an expert surgeon's first 100 raTKAs. The control group included 100 patients that underwent mTKAs from the same surgeon during the same period. The consecutive cases in each group were divided into ten subgroups, each of 10 cases. The groups were comparable concerning age, sex, BMI and Kellgren-Lawrence classification. We compared each subgroup's operative time and complications in mTKA and raTKA groups. We performed a cumsum analysis to construct the ROSA learning curve. RESULTS: The first non-significant difference between the mTKAs and raTKAs operative times was observed in the subgroup of 62 to 71 cases. Till then, the operative time has been significantly lower for the mTKA than the raTKA group. The following groups of tens analysis (8th, 9th and 10th) showed no operative time difference between groups. The learning curve analysis demonstrated that the surgeon switched to the mastering phase from case 73 onwards. The two groups had no complication rate differences. CONCLUSION: Our study demonstrated that about 70 cases are necessary for a senior surgeon to balance operative time between mTKAs and raTKAs using the ROSA system.
目的:关于 ROSA(机器人手术助手)学习曲线的已发表数据有限。本研究评估了一位熟练的骨科医生需要完成多少例手术才能掌握 ROSA 系统,并达到机器人(raTKA)和手动初次全膝关节置换术(mTKA)的手术时间。
方法:这是一项回顾性比较队列研究,纳入了 200 例原发性膝关节骨关节炎患者。研究组由一位经验丰富的外科医生的前 100 例 raTKA 组成。对照组包括在同一时期由同一位外科医生进行的 100 例 mTKA 患者。每组的连续病例分为 10 个亚组,每组 10 例。两组在年龄、性别、BMI 和 Kellgren-Lawrence 分级方面具有可比性。我们比较了每组 mTKA 和 raTKA 组中每个亚组的手术时间和并发症。我们进行了 cum-sum 分析来构建 ROSA 学习曲线。
结果:在 62 至 71 例亚组中,mTKA 和 raTKA 手术时间首次出现无显著差异。直到那时,mTKA 的手术时间一直明显低于 raTKA 组。随后的十个亚组分析(第 8、9 和 10 个)显示两组之间的手术时间没有差异。学习曲线分析表明,外科医生从第 73 例病例开始进入掌握阶段。两组的并发症发生率无差异。
结论:我们的研究表明,大约需要 70 例手术,高级外科医生才能使用 ROSA 系统在 mTKA 和 raTKA 之间平衡手术时间。
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