Koucheki Robert, Wolfstadt Jesse I, Chang Justin S, Backstein David J, Lex Johnathan R
Division of Orthopaedic Surgery, Department of Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada.
Arthroplast Today. 2024 Jun 27;27:101389. doi: 10.1016/j.artd.2024.101389. eCollection 2024 Jun.
Total knee arthroplasty (TKA) is a commonly performed procedure that has traditionally utilized reproducible steps using a set of mechanical instruments. The number of TKAs performed using robotic assistance is increasing, and augmented reality (AR) navigation systems are being developed. Hierarchical task analysis (HTA) aims to describe the steps of a specific task in detail to reduce errors and ensure reproducibility. The objective of this study was to develop and validate HTAs for conventional, robotic-assisted, and AR-navigated TKA.
The development of HTAs for conventional TKA involved an iterative review process that incorporated the input of 4 experienced arthroplasty surgeons. The HTAs were then adapted for robotic-assisted and AR-navigated TKA by incorporating specific steps associated with the use of these systems. The accuracy and completeness of the HTAs were validated by observing 10 conventional and 10 robotic-assisted TKA procedures.
HTAs for conventional, robotic-assisted, and AR-navigated TKA were developed and validated. The resulting HTAs provide a comprehensive and standardized plan for each procedure and can aid in the identification of potential areas of inefficiency and risk. Robotic-assisted and AR-navigated approaches require additional steps, and there are an increased number of instances where complications may occur.
The HTAs developed in this study can provide valuable insights into the potential pitfalls of robotic-assisted and AR-navigated TKA procedures. As AR-navigation systems are developed, they should be optimized by critical analysis using the developed HTAs to ensure maximum efficiency, reliability, accessibility, reduction of human error, and costs.
全膝关节置换术（TKA）是一种常见的手术，传统上使用一套机械器械采用可重复的步骤。使用机器人辅助进行的TKA手术数量正在增加，并且增强现实（AR）导航系统也在不断发展。层次任务分析（HTA）旨在详细描述特定任务的步骤，以减少错误并确保可重复性。本研究的目的是为传统、机器人辅助和AR导航的TKA开发并验证HTA。
传统TKA的HTA开发涉及一个迭代审查过程，该过程纳入了4位经验丰富的关节置换外科医生的意见。然后，通过纳入与这些系统使用相关的特定步骤，将HTA应用于机器人辅助和AR导航的TKA。通过观察10例传统TKA手术和10例机器人辅助TKA手术，验证了HTA的准确性和完整性。
开发并验证了传统、机器人辅助和AR导航TKA的HTA。所得的HTA为每个手术提供了全面且标准化的计划，并有助于识别潜在的效率低下和风险领域。机器人辅助和AR导航方法需要额外的步骤，并且并发症可能发生的情况有所增加。
本研究中开发的HTA可为机器人辅助和AR导航TKA手术的潜在陷阱提供有价值的见解。随着AR导航系统的发展，应使用开发的HTA进行批判性分析，对其进行优化，以确保最高效率、可靠性、可及性、减少人为错误和降低成本。
