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How long does image based robotic total knee arthroplasty take during the learning phase? Analysis of the key steps from the first fifty cases

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Abstract

Introduction

Robotically assisted total knee arthroplasty (RA-TKA) is an emerging surgical tool. The purpose of this study was to analyze the length of time taken to perform the key steps of a RA-TKA for a surgeon and centre new to the MAKO robotic system.

Method

This was a prospective cohort study of the first 50 patients undergoing TKA using a robotic platform (Mako, Stryker, Kalamazoo, MI, USA) performed by a single surgeon. Each key surgical step was recorded. The first 50 patients were chronologically allocated into five groups of ten and compared.

Results

Mean operation length was 59.4 ± 7.4 min with significant improvement after 30 cases. A significant effect on certain steps of the surgery also occurred over 50 cases: after 30 cases for pre-operative planning (3.8 min in group 1 versus 1.2 min in group 4, p < 0.005), ten cases for registration time (5.2 min in group 1 versus 3.8 in group 2, p = 0.039) and ten cases for tibial cutting time (1.6 min in group 1 versus 1.3 in group 2, p < 0.005). Nurse setup, femur cutting, and intraoperative planning did not demonstrate a significant improvement in time over 50 cases.

Conclusion

A significant decrease in total operating length occurred after the 30th case. Anatomical registration and tibial cutting time demonstrated the largest improvements. MAKO image-based robotically assisted TKA is not a time-intensive intervention for both the surgeon and scrub nursing staff, and significant improvements in total surgical time occurs early in the learning phase.

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Data availability

All data related to this study is available upon request.

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Authors and Affiliations

  1. Department of Orthopedic Surgery and Sport Medicine, FIFA Medical Centre of Excellence, Hôpital de La Croix Rousse - Lyon University, 103 Grande Rue de La Croix Rousse, 69004, Lyon, France

    Jobe Shatrov, Constant Foissey, Cécile Batailler, Stanislas Gunst, Elvire Servien & Sébastien Lustig

  2. Sydney Orthopaedic Research Institute (SORI) at Landmark Orthopaedics- St. Leonards, Sydney, Australia

    Jobe Shatrov

  3. Interuniversity Laboratory of Human Movement Science, Université Lyon 1, 7424, Lyon, EA, France

    Elvire Servien

  4. UMR_T9406, Université de Lyon, Université Claude Bernard Lyon 1, IFSTTAR, 69622, Lyon, LBMC, France

    Sébastien Lustig

Authors
  1. Jobe Shatrov
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  2. Constant Foissey
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  3. Cécile Batailler
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  4. Stanislas Gunst
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  5. Elvire Servien
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  6. Sébastien Lustig
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Jobe Shatrov and Constant Foissey. The first draft of the manuscript was written by Jobe Shatrov and Constant Foissey, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jobe Shatrov.

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Ethics approval

Data collection and analysis were carried out in accordance with MR004 Reference Methodology from the Commission Nationale de l'Informatique et des Libertés (Ref. 2226075).

Conflict of interest

Author J.S, C.F, C.B and S.G declare they have no financial interests. ES: Consultant for Corin. Institutional research support from Corin, Amplitude. SL: Royalties from Smith Nephew and Stryker. Consultant for Stryker, Smith Nephew, Heraeus, Depuy Synthes, Groupe Lepine; Institutional research support from Corin, Amplitude; Editorial Board for Journal of Bone and Joint Surgery (Am).

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Level of evidence: IV, prospective cohort study

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Shatrov, J., Foissey, C., Batailler, C. et al. How long does image based robotic total knee arthroplasty take during the learning phase? Analysis of the key steps from the first fifty cases. International Orthopaedics (SICOT) 47, 437–446 (2023). https://doi.org/10.1007/s00264-022-05618-4

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