Putzer David, Schroeder Lennart, Wassilew Georgi, Liebensteiner Michael, Nogler Michael, Thaler Martin
Experimental Orthopaedics, Department of Orthopaedic and Trauma Surgery, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital LMU Munich, 80336 München, Germany.
J Clin Med. 2024 Nov 28;13(23):7253. doi: 10.3390/jcm13237253.
: This study evaluated the learning curve for robotic-assisted total knee arthroplasty (RA TKA) performed by three experienced surgeons, focusing on procedure duration, surgeon satisfaction, and confidence. A prospective study was conducted with three senior arthroplasty surgeons, each performing 15 RA TKA procedures using the Triathlon Knee System with the Robotic Arm Interactive Orthopedic (RIO) System. Data on preparation, cut-to-suture, and breakdown times were collected. Surgeon anxiety levels were measured preoperatively using the STAI-6 scale, while postoperative satisfaction and confidence were assessed via a questionnaire. Statistical analysis was conducted using GraphPad Prism. Of 50 scheduled surgeries, 45 were completed. The average cut-to-suture time was 1 h 38 min, with significant time reductions in robotic-specific steps as experience increased. Comparing the first five surgeries to the last five, the time for navigation hardware mounting, landmarks registration, femur and tibia registration, and bone preparation decreased by up to 30% ( < 0.001 to = 0.025). General instrument preparation time decreased by 20% ( = 0.004). Surgeon anxiety levels dropped, indicating increased comfort with the system, while postoperative surveys showed increased satisfaction and confidence. The study demonstrated a substantial learning curve for RA TKA, with improved efficiency and surgeon confidence by the fifteenth procedure. These findings highlight the potential for streamlined workflows and guide training for new adopters of robotic knee arthroplasty.
本研究评估了三位经验丰富的外科医生进行机器人辅助全膝关节置换术（RA TKA）的学习曲线，重点关注手术时间、外科医生满意度和信心。对三位资深关节置换外科医生进行了一项前瞻性研究，每位医生使用带有机器人手臂交互式骨科（RIO）系统的铁人三项膝关节系统进行15例RA TKA手术。收集了准备、切割到缝合以及分解时间的数据。术前使用STAI - 6量表测量外科医生的焦虑水平，术后通过问卷调查评估满意度和信心。使用GraphPad Prism进行统计分析。在50例计划手术中，45例完成。平均切割到缝合时间为1小时38分钟，随着经验增加，机器人特定步骤的时间显著减少。将前五例手术与后五例手术进行比较，导航硬件安装、地标注册、股骨和胫骨注册以及骨准备的时间减少了高达30%（<0.001至 = 0.025）。一般器械准备时间减少了20%（ = 0.004）。外科医生的焦虑水平下降，表明对该系统的舒适度增加，而术后调查显示满意度和信心提高。该研究表明RA TKA存在显著的学习曲线，到第十五例手术时效率提高且外科医生信心增强。这些发现突出了简化工作流程的潜力，并为机器人膝关节置换术的新采用者提供了培训指导。
