Kishan Patel1, Hyrum Judd2, Richard G Harm3, Joseph R Nolan4, Matthew Hummel1, Jonathon Spanyer1. 1. OrthoCincy Orthopaedics and Sports Medicine, 560 South Loop Rd, Edgewood, KY, 41017, United States. 2. Larkin Hospital Orthopaedic Surgery Residency, 7031 SW 62nd Ave Suite 602, South Miami, FL, 33143, United States. 3. St. Elizabeth Healthcare Clinical Research Institute, 1 Medical village drive, Edgewood, KY, 41017, United States. 4. Northern Kentucky University Department of Mathematics and Statistics, Nunn Dr. Highland Heights, KY, 41099, United States.
Abstract
Aims: Recent studies have attempted to quantify the learning curve associated with integration of robotic technology into surgical practice, but to our knowledge, no study has demonstrated the number of cases needed to reach a steady state of maximum efficiency in operating times using robotic assisted technology. Patients and methods: This was a retrospective analysis of 682 consecutive knees that underwent a robotic-assisted TKA for osteoarthritis by a single surgeon between 2017 and 2020. Procedure times (minutes), length of stay (LOS), and short-term postoperative complications and reoperations were analyzed to define trends. Time series analyses were used to identify the approximate time-point at which a maximum level of surgical operating speed was achieved. Analysis of Variance (ANOVA) and chi-square analyses then followed to compare average procedure duration, LOS, and complications across distinct moving groups of 50 procedures. Results: Time series analyses suggest substantially improved times by the 50th procedure and reached a stable plateau between the 150th and 200th procedure. Average duration for the first 50 procedures was approximately 85 min, dropping to 69 min for procedures 51-100, 66 min for procedures 101-150, and then plateauing at approximately 61 min for procedures 151-682, demonstrating significant improvements in surgical efficiency at each 50-procedure interval (p < 0.05). There was no significant difference in LOS, readmissions, and reoperations with increasing groups of 50 procedures performed. Conclusion: Results from this study will allow surgeons to better understand the implications of integrating robotic arm-assisted technology into their practice. Surgeons can expect significant improvement of their operative time following completion of at least 50 procedures, while likely reaching a maximum level of surgical efficiency between 151 and 200 procedures.
Aims: Recent studies have attempted to quantify the learning curve associated with integration of robotic technology into surgical practice, but to our knowledge, no study has demonstrated the number of cases needed to reach a steady state of maximum efficiency in operating times using robotic assisted technology. Patients and methods: This was a retrospective analysis of 682 consecutive knees that underwent a robotic-assisted TKA for osteoarthritis by a single surgeon between 2017 and 2020. Procedure times (minutes), length of stay (LOS), and short-term postoperative complications and reoperations were analyzed to define trends. Time series analyses were used to identify the approximate time-point at which a maximum level of surgical operating speed was achieved. Analysis of Variance (ANOVA) and chi-square analyses then followed to compare average procedure duration, LOS, and complications across distinct moving groups of 50 procedures. Results: Time series analyses suggest substantially improved times by the 50th procedure and reached a stable plateau between the 150th and 200th procedure. Average duration for the first 50 procedures was approximately 85 min, dropping to 69 min for procedures 51-100, 66 min for procedures 101-150, and then plateauing at approximately 61 min for procedures 151-682, demonstrating significant improvements in surgical efficiency at each 50-procedure interval (p < 0.05). There was no significant difference in LOS, readmissions, and reoperations with increasing groups of 50 procedures performed. Conclusion: Results from this study will allow surgeons to better understand the implications of integrating robotic arm-assisted technology into their practice. Surgeons can expect significant improvement of their operative time following completion of at least 50 procedures, while likely reaching a maximum level of surgical efficiency between 151 and 200 procedures.
Authors: Ming Han Lincoln Liow; Zhan Xia; Merng Koon Wong; Keng Jin Tay; Seng Jin Yeo; Pak Lin Chin Journal: J Arthroplasty Date: 2013-12-14 Impact factor: 4.757
Authors: Austin F Smith; Christian J Eccles; Samrath J Bhimani; Kevin M Denehy; Rohat B Bhimani; Langan S Smith; Arthur L Malkani Journal: J Knee Surg Date: 2019-11-15 Impact factor: 2.757
Authors: Kevin B Marchand; Joseph Ehiorobo; Kevin K Mathew; Robert C Marchand; Michael A Mont Journal: J Knee Surg Date: 2020-08-24 Impact factor: 2.757
Authors: Hannes Vermue; Thomas Luyckx; Philip Winnock de Grave; Alexander Ryckaert; Anne-Sophie Cools; Nicolas Himpe; Jan Victor Journal: Knee Surg Sports Traumatol Arthrosc Date: 2020-11-03 Impact factor: 4.114
Authors: Junren Zhang; Wofhatwa Solomon Ndou; Nathan Ng; Paul Gaston; Philip M Simpson; Gavin J Macpherson; James T Patton; Nicholas D Clement Journal: Knee Surg Sports Traumatol Arthrosc Date: 2021-02-06 Impact factor: 4.114