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. 2023 Apr 27;24(1):332.
doi: 10.1186/s12891-023-06422-w.

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

Ho Jung Jung #  1 , Min Wook Kang #  1 , Jong Hwa Lee  1 , Joong Il Kim  2
Affiliations

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

Ho Jung Jung et al. BMC Musculoskelet Disord. .

Erratum in

Abstract

Background: Robot-assisted total knee arthroplasty (r-TKA) can reportedly achieve more accurate implant positioning than conventional total knee arthroplasty (c-TKA), although its learning curve is controversial. Moreover, few studies have investigated r-TKA in Asians, who have different anatomical characteristics. This study aimed to determine the learning curve for r-TKA and compare implant positions between r-TKA and c-TKA according to the learning curve in Asian patients.

Methods: This prospective study included 50 consecutive c-TKAs (group C), followed by 50 consecutive r-TKAs conducted using the MAKO robotic system (Stryker, USA). Cumulative summation analyses were performed to assess the learning curve for operative time in r-TKA. Accordingly, the r-TKA cases were divided into the initial (group I) and proficiency cases (group P). The femoral and tibial component positions in the coronal, sagittal, and axial planes and lower limb alignment were compared among the three groups.

Results: r-TKA was associated with a learning curve for operative time in 18 cases. The operative time was significantly shorter in groups C and P than that in group I, with no significant difference between groups C and P. Groups I and P demonstrated fewer outliers with respect to lower limb alignment, femoral component coronal position, axial position, and tibial component sagittal position than those in group C, with no significant difference between groups I and P.

Conclusion: The operative time did not differ significantly between r-TKA and c-TKA after the learning curve. Surgeons could expect more accurate and reproducible lower limb alignment and implant positioning with r-TKA in Asian patients, irrespective of the learning curve.

Keywords: Learning curve; Lower limb alignment; Operative time; Robotic surgery; Total knee arthroplasty.

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Conflict of interest statement

There are no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Flow diagram of patient enrollment * c-TKA, conventional total knee arthroplasty; r-TKA, robot-assisted total knee arthroplasty; group C, conventional total knee arthroplasty group; group I, initial phase group; group P, proficiency phase group
Fig. 2
Fig. 2
Component position angle on radiograpy. CFA was determined as the medial angle between the line connecting the femoral component condyles and the mechanical axis of the femur. CTA was defined as the medial angle between the horizontal tibial tray and the mechanical axis of the tibia. SFA was the proximal angle between the line perpendicular to the distal cement surface and the anatomical axis of the femur. STA was defined as the angle between the axis of the horizontal tibial tray and the anatomical axis of the tibia *CFA, coronal femoral alignment; CTA, coronal tibial alignment; SFA, sagittal femoral alignment; STA, sagittal tibial alignment
Fig. 3
Fig. 3
Component position angle on CT. The FCR was determined as the angle between the sTEA and PCA *CT, computer tomography; FCR, femoral component rotation; sTEA, surgical transepicondylar axis; PCA, posterior condylar axis
Fig. 4
Fig. 4
Chart of CUSUM analysis for r-TKA. r-TKA was associated with a learning curve for operative time in 18 cases. * CUSUM, cumulative summation; r-TKA, robot-assisted total knee arthroplasty
See this image and copyright information in PMC

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