The learning curve associated with robotic-arm assisted unicompartmental knee arthroplasty A PROSPECTIVE COHORT STUDY

被引:102
作者
Kayani, B. [1 ,2 ]
Konan, S. [1 ,2 ]
Pietrzak, J. R. T. [1 ,2 ]
Huq, S. S. [1 ,2 ,3 ]
Tahmassebi, J. [1 ,2 ,3 ]
Haddad, F. S. [1 ,2 ,4 ,5 ]
机构
[1] Princess Grace Hosp, London, England
[2] Univ Coll Hosp, London, England
[3] Univ Coll Hosp, Dept Trauma & Orthopaed, London, England
[4] Univ Coll London Hosp, Orthopaed Surg, Princess Grace Hosp, London, England
[5] UCLH, NIHR Biomed Res Ctr, London, England
关键词
REPLACEMENT;
D O I
10.1302/0301-620X.100B8.BJJ-2018-0040.R1
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Aims The primary aim of this study was to determine the surgical team's learning curve for introducing robotic-arm assisted unicompartmental knee arthroplasty (UKA) into routine surgical practice. The secondary objective was to compare accuracy of implant positioning in conventional jig-based UKA versus robotic-arm assisted UKA. Patients and Methods This prospective single-surgeon cohort study included 60 consecutive conventional jig-based UKAs compared with 60 consecutive robotic-arm assisted UKAs for medial compartment knee osteoarthritis. Patients undergoing conventional UKA and robotic-arm assisted UKA were well-matched for baseline characteristics including a mean age of 65.5 years (SD 6.8) vs 64.1 years (SD 8.7), (p = 0.31); a mean body mass index of 27.2 kg.m(2) (SD 2.7) vs 28.1 kg.m(2) (SD 4.5), (p = 0.25); and gender (27 males: 33 females vs 26 males: 34 females, p = 0.85). Surrogate measures of the learning curve were prospectively collected. These included operative times, the Spielberger State-Trait Anxiety Inventory (STAI) questionnaire to assess preoperative stress levels amongst the surgical team, accuracy of implant positioning, limb alignment, and postoperative complications. Results Robotic-arm assisted UKA was associated with a learning curve of six cases for operating time (p < 0.001) and surgical team confidence levels (p < 0.001). Cumulative robotic experience did not affect accuracy of implant positioning (p = 0.52), posterior condylar offset ratio (p = 0.71), posterior tibial slope (p = 0.68), native joint line preservation (p = 0.55), and postoperative limb alignment (p = 0.65). Robotic-arm assisted UKA improved accuracy of femoral (p < 0.001) and tibial (p < 0.001) implant positioning with no additional risk of postoperative complications compared to conventional jig-based UKA. Conclusion Robotic-arm assisted UKA was associated with a learning curve of six cases for operating time and surgical team confidence levels but no learning curve for accuracy of implant positioning.
引用
收藏
页码:1033 / 1042
页数:10
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