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Operating room efficiency for a high-volume surgeon in simultaneous bilateral robotic-assisted total knee arthroplasty: a prospective cohort study

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Abstract

Robotic-assisted total knee arthroplasty (RATKA) has been shown to achieve more accurate component positioning and target alignment than conventional jig-based instrumentation; however, concerns remain regarding its adoption since it is associated with steep learning curves, higher operational costs, and increased surgical time. This study aims to compare the operating times of three cohorts of patients undergoing simultaneous bilateral TKA, i.e., first 50 RATKA, last 50 RATKA (at the end of 1 year), and 50 conventional TKA. This prospective cohort study was conducted at a single high-volume tertiary care center by a single experienced surgeon on 150 patients (300 knees), who were allotted into three equal cohorts of 50, between February 2020 and December 2021. Simultaneous bilateral TKAs were done in all three groups and operative times recorded. We describe the technique for optimizing the surgical time of SB-RATKA for efficient operative room logistics. The operating times of the two robotic-assisted TKA cohorts were compared with the operating times of the conventional SB-TKA cohort. The mean age of the study population was 59(±6.2) years with the majority of females (82%). The mean coronal deformity was comparable between the cohorts. The mean operating time in the conventional CTKA, initial 50 RATKA, and final 50 RATKA cohorts were 115.56 (±10.7), 127.8 (±26), and 91.66 (±13.5) min, respectively, all of which showed a statistically significant difference (p < 0.001). The mean operating times of the final 50 RATKA at the end of 1 year improved by about 36 min with all the SB-RATKA cases being completed in under 120 min. The efficiency of SB-RATKA improved significantly with time and experience, resulting in shorter operational times within a year, revealing the potential of robotic-assisted surgery to surpass conventional approaches in TKA in terms of operating room efficiency.

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Data availability

No datasets were generated or analyzed during the current study.

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Not applicable.

Abbreviations

RATKA:

Robotic-assisted total knee arthroplasty

CTKA:

Conventional total knee arthroplasty

SB-RATKA:

Simultaneous bilateral robotic-assisted TKA

SB-CTKA:

Simultaneous bilateral conventional TKA

ACB:

Adductor canal block

UPS:

Uninterrupted power supply

OR:

Operating room

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Authors and Affiliations

  1. Sunshine Bone and Joint Institute, KIMS-Sunshine Hospitals, Hyderabad, India

    A. B. Suhas Masilamani, Praharsha Mulpur, Tarun Jayakumar, Kushal Hippalgaonkar & A. V. Gurava Reddy

  2. Indraprastha Apollo Hospitals, New Delhi, India

    Sandeep Boddeda & Raju Vaishya

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Contributions

CRediT author statement. ABSM: conceptualization, methodology, writing—reviewing, editing, and final approval. PM: conceptualization, writing—reviewing, editing, and final approval. TJ: writing—original draft, data curation, investigation, and formal analysis. SB: data curation, writing—reviewing, and editing. KH: writing—reviewing, editing, and final approval. RV: writing—reviewing, editing, and final approval. AVGR: conceptualization, writing—reviewing, editing, and final approval.

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Correspondence to Tarun Jayakumar.

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Masilamani, A.B.S., Mulpur, P., Jayakumar, T. et al. Operating room efficiency for a high-volume surgeon in simultaneous bilateral robotic-assisted total knee arthroplasty: a prospective cohort study. J Robotic Surg 18, 188 (2024). https://doi.org/10.1007/s11701-024-01947-1

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