METHODS: In this retrospective observational study, we examined 110 medical records from 95 patients who underwent ROSA-assisted TKA performed by three surgeons. We employed the cumulative summation methodology to assess the learning curves related to operative time. Furthermore, we evaluated the accuracy of the ROSA Knee System in performing TKA by comparing planned versus validated values for femoral and tibial bone cuts and angles.
RESULTS: The learning curve for the ROSA Knee System spanned 14, 14, and 6 cases for the respective surgeons, with operative times decreasing by 22 min upon reaching proficiency (70.8 vs. 48.9 min; p < 0.001). Significant discrepancies were observed between the average planned and validated cuts and angles for femoral bone cuts (0.4 degree ± 2.4 for femoral flexion, 0.1 degree ± 0.6 for femoral coronal alignment, 0.3 mm ± 1.2 for distal medial femoral resection, 1.4 mm ± 8.8 for distal lateral femoral resection) and hip-knee-ankle axis alignment (0.3 degree ± 1.9 )(p < 0.05) but not for tibial bone cuts. Differences between planned and validated measurements during the learning and proficiency phases were nonsignificant across all parameters, except for the femoral flexion angle (0.42 degree ± 0.8 vs. 0.44 degree ± 2.7) (p = 0.49).
CONCLUSIONS: The ROSA Knee System can be integrated into surgical workflows after a modest learning curve of 6 to 14 cases. The system demonstrated high accuracy and reproducibility, particularly for tibial bone cuts. Acknowledging the learning curve associated with new robot-assisted TKA technologies is vital for their effective implementation.
方法:在这项回顾性观察研究中,我们检查了由3名外科医生进行ROSA辅助TKA的95例患者的110份病历.我们采用累积求和方法来评估与手术时间相关的学习曲线。此外,我们通过比较股骨和胫骨骨切口和角度的计划值和验证值,评估了ROSA膝关节系统进行TKA的准确性.
结果:ROSA膝关节系统的学习曲线跨越14、14和6例,分别适用于外科医生,手术时间在达到熟练程度后减少22分钟(70.8与48.9分钟;p<0.001)。在股骨骨切割的平均计划和验证的切割和角度之间观察到显着差异(股骨屈曲的0.4度±2.4,股骨冠状排列0.1度±0.6,股骨远端内侧切除术0.3mm±1.2,对于股骨远端外侧切除术为1.4mm±8.8)和髋-膝-踝轴对齐(0.3度±1.9)(p<0.05),但对于胫骨骨切割则不适用。在学习和熟练阶段,计划和验证的测量之间的差异在所有参数中都不显著,除了股骨屈曲角度(0.42度±0.8vs.0.44度±2.7)(p=0.49)。
结论:ROSA膝关节系统可以在6至14例的适度学习曲线后整合到手术工作流程中。该系统具有较高的准确性和可重复性,特别是胫骨骨切割。认识到与新的机器人辅助TKA技术相关的学习曲线对于其有效实施至关重要。