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机器人辅助全膝关节置换术的早期学习曲线:单中心经验

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

作者信息

Putzer David, Schroeder Lennart, Wassilew Georgi, Liebensteiner Michael, Nogler Michael, Thaler Martin

机构信息

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.

出版信息

J Clin Med. 2024 Nov 28;13(23):7253. doi: 10.3390/jcm13237253.


DOI:10.3390/jcm13237253
PMID:39685712
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11641829/
Abstract

: 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.

摘要

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。

相似文献

[1]
Early Learning Curve in Robotic-Assisted Total Knee Arthroplasty: A Single-Center Experience.

J Clin Med. 2024-11-28

[2]
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

[3]
Cementless, Cruciate-Retaining Primary Total Knee Arthroplasty Using Conventional Instrumentation: Technical Pearls and Intraoperative Considerations.

JBJS Essent Surg Tech. 2024-9-13

[4]
Learning curve analysis of robotic-assisted total knee arthroplasty with a Chinese surgical system.

J Orthop Surg Res. 2023-11-27

[5]
The learning curve in robotic assisted knee arthroplasty is flattened by the presence of a surgeon experienced with robotic assisted surgery.

Knee Surg Sports Traumatol Arthrosc. 2023-3

[6]
Robotic-arm assisted total knee arthroplasty has a learning curve of 16 cases and increased operative time of 12 min.

ANZ J Surg. 2022-11

[7]
Robotic-Assisted Total Knee Arthroplasty Allows for Trainee Involvement and Teaching Without Lengthening Operative Time.

J Arthroplasty. 2022-6

[8]
The learning curve associated with robotic-arm assisted unicompartmental knee arthroplasty: a prospective cohort study.

Bone Joint J. 2018-8

[9]
Learning Curve of Robotic-Assisted Total Knee Arthroplasty for Non-Fellowship-Trained Orthopedic Surgeons.

Arthroplast Today. 2022-1-22

[10]
Imageless robotic handpiece-assisted total knee arthroplasty: a learning curve analysis of surgical time and alignment accuracy.

Arch Orthop Trauma Surg. 2021-12

引用本文的文献

[1]
Robotic total hip and knee arthroplasty: economic impact and workflow efficiency.

J Robot Surg. 2025-9-8

[2]
Learning curve of robotic-assisted total knee arthroplasty: a literature review.

J Robot Surg. 2025-7-22

本文引用的文献

[1]
Robot-assisted knee arthroplasty: Analyzing the learning curve and initial institutional experience.

Comput Struct Biotechnol J. 2024-4-12

[2]
Analysis of robot-specific operative time and surgical team anxiety level and its effect on alignment during robot-assisted TKA.

J Robot Surg. 2024-2-22

[3]
Initial Learning Curve for Robot-Assisted Total Knee Arthroplasty in a Dedicated Orthopedics Center.

J Clin Med. 2023-11-6

[4]
Learning curve of robot-assisted total knee arthroplasty and its effects on implant position in asian patients: a prospective study.

BMC Musculoskelet Disord. 2023-4-27

[5]
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

[6]
Cost-effectiveness analysis of robotic-arm assisted total knee arthroplasty.

PLoS One. 2022

[7]
Robotic-arm assisted total knee arthroplasty has a learning curve of 16 cases and increased operative time of 12 min.

ANZ J Surg. 2022-11

[8]
The learning curve of imageless robot-assisted total knee arthroplasty with standardised laxity testing requires the completion of nine cases, but does not reach time neutrality compared to conventional surgery.

Int Orthop. 2023-2

[9]
The Ability of Robot-Assisted Total Knee Arthroplasty in Matching the Efficiency of Its Conventional Counterpart at an Orthopaedic Specialty Hospital.

J Arthroplasty. 2023-1

[10]
The learning curve in robotic assisted knee arthroplasty is flattened by the presence of a surgeon experienced with robotic assisted surgery.

Knee Surg Sports Traumatol Arthrosc. 2023-3

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