Robotic-arm assisted total knee arthroplasty has a learning curve of seven cases for integration into the surgical workflow but no learning curve effect for accuracy of implant positioning.
Robotic-arm assisted total knee arthroplasty has a learning curve of seven cases for integration into the surgical workflow but no learning curve effect for accuracy of implant positioning.
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DOI：
10.1007/s00167-018-5138-5
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发表时间：
2019-04
期刊：
影响因子：
--
通讯作者：
Haddad FS
中科院分区：
文献类型：
--
作者：
Kayani B;Konan S;Huq SS;Tahmassebi J;Haddad FS
这项研究的主要目的是通过评估手术时间、手术团队舒适度、植入物定位的准确性、肢体对齐和术后并发症来确定手术团队对机械臂辅助全膝关节置换术的学习曲线。次要目标是比较传统的基于夹具的全膝关节置换术和机械臂辅助的全膝关节置换术在种植体定位和肢体对齐方面的准确性。这项前瞻性队列研究包括60个连续的基于夹具的传统全膝关节置换术，以及60个连续的机械臂辅助的全膝关节置换术，由一个外科医生完成。独立观察者记录了学习曲线的替代标记物，包括手术时间、手术团队使用状态-特质焦虑量表(STAI)问卷的压力水平、植入物定位的准确性、肢体对齐以及手术后30天内的并发症。累积和(CUSUM)分析用于评估机器人全膝关节置换术(TKA)手术时间和STAI评分的学习曲线。机械臂辅助的全膝关节置换术与7例手术时间的学习曲线(p = 0.01)和手术团队的焦虑水平(p = 0.02)相关。累积的机器人经验不会影响种植体定位的准确性(N.S.)肢体对齐(N.S.)后髁突偏移率(N.S.)胫骨后倾角(N.S.)和联合线路恢复(N.S.)。与传统的人工全膝关节置换术相比，机器人全膝关节置换术提高了植入物定位(p <； 0.001)和肢体对齐(p <； 0.001)的准确性，且不会增加术后并发症的风险。在最初的7个病例中，机械臂辅助全膝关节置换术的实施增加了手术时间，增加了手术团队的焦虑程度，但没有学习曲线来实现计划的植入物定位。与传统的基于夹具的TKA相比，机械臂辅助的TKA提高了植入物定位和肢体对齐的准确性。这项研究的结果将使临床医生和医疗保健专业人员能够更好地了解实施机器人TKA对手术工作流程的影响，帮助将该程序安全地整合到外科实践中，并在学习阶段促进手术病例的剧场规划和调度。二、
The primary objective of this study was to determine the surgical team’s learning curve for robotic-arm assisted TKA through assessments of operative times, surgical team comfort levels, accuracy of implant positioning, limb alignment, and postoperative complications. Secondary objectives were to compare accuracy of implant positioning and limb alignment in conventional jig-based TKA versus robotic-arm assisted TKA. This prospective cohort study included 60 consecutive conventional jig-based TKAs followed by 60 consecutive robotic-arm assisted TKAs performed by a single surgeon. Independent observers recorded surrogate markers of the learning curve including operative times, stress levels amongst the surgical team using the state-trait anxiety inventory (STAI) questionnaire, accuracy of implant positioning, limb alignment, and complications within 30 days of surgery. Cumulative summation (CUSUM) analyses were used to assess learning curves for operative time and STAI scores in robotic TKA. Robotic-arm assisted TKA was associated with a learning curve of seven cases for operative times (p = 0.01) and surgical team anxiety levels (p = 0.02). Cumulative robotic experience did not affect accuracy of implant positioning (n.s.) limb alignment (n.s.) posterior condylar offset ratio (n.s.) posterior tibial slope (n.s.) and joint line restoration (n.s.). Robotic TKA improved accuracy of implant positioning (p < 0.001) and limb alignment (p < 0.001) with no additional risk of postoperative complications compared to conventional manual TKA. Implementation of robotic-arm assisted TKA led to increased operative times and heightened levels of anxiety amongst the surgical team for the initial seven cases but there was no learning curve for achieving the planned implant positioning. Robotic-arm assisted TKA improved accuracy of implant positioning and limb alignment compared to conventional jig-based TKA. The findings of this study will enable clinicians and healthcare professionals to better understand the impact of implementing robotic TKA on the surgical workflow, assist the safe integration of this procedure into surgical practice, and facilitate theatre planning and scheduling of operative cases during the learning phase. II.
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影响因子：
5.3
作者：
Parratte, Sebastien;Pagnano, Mark W.;Berry, Daniel J.
通讯作者：
Berry, Daniel J.
DOI：
10.1097/011.blo.0000238825.63648.1e
发表时间：
2006-11-01
影响因子：
4.2
作者：
Noble, Philip C.;Conditt, Michael A.;Mathis, Kenneth B.
通讯作者：
Mathis, Kenneth B.
DOI：
10.1302/0301-620x.73b5.1894655
发表时间：
1991-09-01
影响因子：
--
作者：
JEFFERY, RS;MORRIS, RW;DENHAM, RA
通讯作者：
DENHAM, RA
影响因子：
5.3
作者：
Bell, Stuart W.;Anthony, Iain;Blyth, Mark
通讯作者：
Blyth, Mark
影响因子：
3.5
作者：
Kansara, Devanshu;Markel, David C.
通讯作者：
Markel, David C.