Learning curves of robotic technology in an orthopedic teaching hospital

BACKGROUNDIn recent years there has been an increasing implementation of robotic technology in arthroplasty. Due to the unclear data situation the aim of this study was to analyze the learning curve for robotic technology in residency training. METHODSAfter its introduction, the first 351 consecutive robotic knee replacements were prospectively included in the study. Surgical times, preoperative and postoperative radiographs, intraoperatively recorded alignment data and complications were analyzed. Satisfaction, revision, and referral rates were determined in a 90-day follow-up survey. Data from the last 350 navigated total knee arthroplasties were analyzed as a historical control group. RESULTSA learning curve of between 3 and 53 procedures was identified, depending on the surgeon, with further reductions in time measured even after 1 year of use. The operative times of the navigated technique were achieved by all surgeons. With respect to precision (alignment outliers) and patient satisfaction rate, no learning curve was evident. Comparison between tutorial and non-tutorial surgery showed a 16-min increase in operating time, but no significant differences in precision, complications, and patient satisfaction rate. CONCLUSIONThe study showed that there was a learning curve in terms of duration of surgery but not in terms of precision, complications, and patient satisfaction. Robotic tutorial surgery requires more time but provides the same outcome compared to experienced surgeons. Thus, the robotic surgical technique appears to be an excellent training tool in knee arthroplasty.