Messe Simon, Mesnard Guillaume, Vermue Hannes, Festa Enrico, Servien Elvire, Viste Anthony, Batailler Cécile, Lustig Sébastien
Univ Lyon, Claude Bernard Lyon 1 University, IFSTTAR, LBMC UMR_T9406, 43 boulevard du 11 Novembre 1918, 69622 Villeurbanne Cedex, France - Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Lyon University Hospital, 103 Grande Rue de la Croix Rousse, 69004 Lyon, France.
Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Lyon University Hospital, 103 Grande Rue de la Croix Rousse, 69004 Lyon, France.
SICOT J. 2025;11:45. doi: 10.1051/sicotj/2025041. Epub 2025 Aug 7.
The learning curve associated with adopting new surgical systems in total knee arthroplasty (TKA) can significantly impact surgical efficiency and patient outcomes. This study aimed to evaluate the evolution of operative time with the KNEO (Groupe Lépine, Genay, France) posterior stabilized knee system and to analyze the learning curve for postoperative complications to achieve surgical proficiency.
This retrospective, multicentric study analyzed 481 patients who underwent primary TKA with the KNEO implant in a high-volume university center between 2020 and 2024. The evolution of operative time and postoperative complications requiring reoperation surgery were evaluated, with a follow-up period extending until January 2025, during which complications were monitored. The study included 481 patients with a mean age of 71.7 ± 8.0 years and a mean Body Mass Index of 29.0 ± 4.0 kg/m. The cohort comprised 308 female (64%) and 173 male (36%) patients.
The mean operative time significantly decreased from 83.5 min in the initial case to 63.0 min after 481 cases (p < 0.001). The learning curve showed an initial learning phase with high variability, followed by stabilization around 150 procedures and subsequent optimization. Postoperative complication rates showed a 31.9% reduction per group of 100 patients (β = -0.3848, p = 0.0075), indicating improved surgical proficiency and patient safety over time.
The findings suggest that the KNEO system follows a measurable learning curve, with operative efficiency and complication rates improving as case volume increases. These results emphasize the importance of structured training and experience accumulation in optimizing patient outcomes when implementing new implant technologies.
在全膝关节置换术（TKA）中采用新手术系统相关的学习曲线会显著影响手术效率和患者预后。本研究旨在评估使用KNEO（法国热奈市勒皮纳集团）后稳定型膝关节系统时手术时间的变化，并分析术后并发症的学习曲线以实现手术熟练程度。
这项回顾性多中心研究分析了2020年至2024年期间在一家大型大学中心接受KNEO植入物初次全膝关节置换术的481例患者。评估了手术时间的变化以及需要再次手术的术后并发症情况，随访期延长至2025年1月，在此期间监测并发症。该研究纳入了481例患者，平均年龄为71.7±8.0岁，平均体重指数为29.0±4.0kg/m²。队列包括308例女性（64%）和173例男性（36%）患者。
平均手术时间从最初病例的83.5分钟显著降至481例后的63.0分钟（p<0.001）。学习曲线显示出一个初始学习阶段，变异性较高，随后在约150例手术时趋于稳定并随后得到优化。术后并发症发生率显示每100例患者每组降低31.9%（β=-0.3848，p=0.0075），表明随着时间推移手术熟练程度提高且患者安全性改善。
研究结果表明，KNEO系统呈现出可测量的学习曲线，随着病例数量增加手术效率和并发症发生率得到改善。这些结果强调了在采用新植入技术时进行结构化培训和积累经验对于优化患者预后的重要性。
