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ROSA 学习曲线:机器人辅助与手动初次全膝关节置换术手术时间匹配所需的病例数。

The learning curve to ROSA: cases needed to match the surgery time between a robotic-assisted and a manual primary total knee arthroplasty.

机构信息

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.

出版信息

Eur J Orthop Surg Traumatol. 2023 Dec;33(8):3357-3363. doi: 10.1007/s00590-023-03554-6. Epub 2023 Apr 27.


DOI:10.1007/s00590-023-03554-6
PMID:37103617
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10134708/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3218/10651529/dc16189dd58e/590_2023_3554_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3218/10651529/9da837e15222/590_2023_3554_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3218/10651529/dc16189dd58e/590_2023_3554_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3218/10651529/9da837e15222/590_2023_3554_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3218/10651529/dc16189dd58e/590_2023_3554_Fig2_HTML.jpg

相似文献

[1]
The learning curve to ROSA: cases needed to match the surgery time between a robotic-assisted and a manual primary total knee arthroplasty.

Eur J Orthop Surg Traumatol. 2023-12

[2]
Comparative outcomes between a new robotically assisted and a manual technique for total knee arthroplasty in patients with osteoarthritis: a prospective matched comparative cohort study.

Eur J Orthop Surg Traumatol. 2023-5

[3]
Analysis of the Initial Learning Curve for Robotic-Assisted Total Knee Arthroplasty Using the ROSA Knee System.

J Clin Med. 2024-6-6

[4]
Learning Curve of Robotic-Assisted Total Knee Arthroplasty for a High-Volume Surgeon.

J Knee Surg. 2022-3

[5]
The initial learning curve for the ROSA® Knee System can be achieved in 6-11 cases for operative time and has similar 90-day complication rates with improved implant alignment compared to manual instrumentation in total knee arthroplasty.

J Exp Orthop. 2021-12-20

[6]
Comparative Cost Analysis of Robotic-Assisted and Jig-Based Manual Primary Total Knee Arthroplasty.

J Knee Surg. 2022-1

[7]
Robotic-arm assisted total knee arthroplasty is associated with improved accuracy and patient reported outcomes: a systematic review and meta-analysis.

Knee Surg Sports Traumatol Arthrosc. 2022-8

[8]
The ROSA knee robotic system demonstrates superior precision in restoring joint line height and posterior condylar offset compared to conventional manual TKA: a retrospective case-control study.

Eur J Orthop Surg Traumatol. 2024-7

[9]
A novel robotic surgical assistant for total knee arthroplasty has a learning curve ranging from 6 to 14 cases and exhibits high accuracy in tibial bone cuts.

J Orthop Surg Res. 2024-8-17

[10]
Robotic-arm assisted total knee arthroplasty has a learning curve of seven cases for integration into the surgical workflow but no learning curve effect for accuracy of implant positioning.

Knee Surg Sports Traumatol Arthrosc. 2018-9-17

引用本文的文献

[1]
The learning curve of robotic-assisted total knee arthroplasty: a systematic review and meta-analysis.

J Robot Surg. 2025-8-6

[2]
Robotic Guided Knee Arthroplasty - Group Learning Curve and Early Outcomes.

Arthroplast Today. 2025-7-2

[3]
Evaluation of the learning curve in robot-assisted knee arthroplasty: A Systematic review.

J Exp Orthop. 2025-7-13

[4]
Improved Efficiency and Intraoperative Planning With 1 Robot-Assisted Total Knee Arthroplasty System.

Arthroplast Today. 2025-4-8

[5]
Rapid reduction in surgical time and high level of accuracy in alignment and femoral component size prediction in robotic-assisted total knee arthroplasty with ROSA Knee System.

J Exp Orthop. 2025-1-27

[6]
Accuracy of the Imageless Mode of the ROSA Robotic System for Targeted Resection Thickness in Total Knee Arthroplasty: A Prospective, Single Surgeon Case-Series Study.

Int J Med Robot. 2024-12

[7]
Early Learning Curve in Robotic-Assisted Total Knee Arthroplasty: A Single-Center Experience.

J Clin Med. 2024-11-28

[8]
Robotic arm-assisted versus conventional total knee arthroplasty: comparing complications, costs, and postoperative opioid use in propensity-matched cohorts.

Eur J Orthop Surg Traumatol. 2024-12

[9]
Accuracy and Outcomes of a Novel Cut-Block Positioning Robotic-Arm Assisted System for Total Knee Arthroplasty: A Systematic Review and Meta-Analysis.

Arthroplast Today. 2024-8-4

[10]
Robot-assisted knee arthroplasty: Analyzing the learning curve and initial institutional experience.

Comput Struct Biotechnol J. 2024-4-12

本文引用的文献

[1]
Risk of complications with prolonged operative time in morbidly obese patients undergoing elective total knee arthroplasty.

Arthroplasty. 2023-2-2

[2]
Introduction of ROSA robotic-arm system for total knee arthroplasty is associated with a minimal learning curve for operative time.

J Exp Orthop. 2022-12

[3]
Learning curve for robotic assisted total knee arthroplasty: our experience with imageless hand-held Navio system.

J Robot Surg. 2023-4

[4]
Comparative outcomes between a new robotically assisted and a manual technique for total knee arthroplasty in patients with osteoarthritis: a prospective matched comparative cohort study.

Eur J Orthop Surg Traumatol. 2023-5

[5]
Time-Based Learning Curve for Robotic-Assisted Total Knee Arthroplasty: A Multicenter Study.

J Knee Surg. 2023-7

[6]
The initial learning curve for the ROSA® Knee System can be achieved in 6-11 cases for operative time and has similar 90-day complication rates with improved implant alignment compared to manual instrumentation in total knee arthroplasty.

J Exp Orthop. 2021-12-20

[7]
Learning curve for active robotic total knee arthroplasty.

Knee Surg Sports Traumatol Arthrosc. 2022-8

[8]
Robot-assisted total knee arthroplasty is associated with a learning curve for surgical time but not for component alignment, limb alignment and gap balancing.

Knee Surg Sports Traumatol Arthrosc. 2022-2

[9]
Learning Curve of Robotic-Assisted Total Knee Arthroplasty for a High-Volume Surgeon.

J Knee Surg. 2022-3

[10]
Robotic-arm assisted total knee arthroplasty has a learning curve of seven cases for integration into the surgical workflow but no learning curve effect for accuracy of implant positioning.

Knee Surg Sports Traumatol Arthrosc. 2018-9-17

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