{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T15:49:46Z","timestamp":1793980186408,"version":"4.8.0"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,8,30]],"date-time":"2022-08-30T00:00:00Z","timestamp":1661817600000},"content-version":"vor","delay-in-days":241,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,8,30]],"date-time":"2022-08-30T00:00:00Z","timestamp":1661817600000},"content-version":"vor","delay-in-days":241,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The introduction of robotics for total knee arthroplasty (TKA) into the operating theatre is often associated with a learning curve and is potentially associated with additional complications. The purpose of this study was to determine the learning curve of robotic\u2010assisted (RA) TKA within a multi\u2010surgeon team.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective cohort study included 83 consecutive conventional jig\u2010based TKAs compared with 53 RA TKAs using the Robotic Surgical Assistant (ROSA) system (Zimmer Biomet, Warsaw, Indiana, USA) for knee osteoarthritis performed by three high\u2010volume (&gt; 100 TKA per year) orthopaedic surgeons. Baseline characteristics including age, BMI, sex and pre\u2010operative Kellgren\u2010Lawrence graded and Hip\u2010Knee\u2010Ankle Axis were well\u2010matched between the conventional and RA TKA groups. Cumulative summation (CUSUM) analysis was used to assess learning curves for operative times for each surgeon. Peri\u2010operative and delayed complications (infection, periprosthetic fracture, thromboembolism, and compromised wound healing) and revisions were reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The CUSUM analysis for operative time demonstrated an inflexion point after 5, 6 and 15 cases for each of the three surgeons, or 8.7 cases on average. There were no significant differences (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.53) in operative times between the RA TKA learning (before inflexion point) and proficiency (after inflexion point) phases. Similarly, the operative times of the RA TKA group did not differ significantly (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.92) from the conventional TKA group. There was no discernible learning curve for the accuracy of component planning using the RA TKA system. The average length of post\u2010operative follow\u2010up was 21.3 \u00b1 9.0\u00a0months. There was one revision for instability in the conventional TKA group and none in the RA TKA group. There were no significant difference (\n                      <jats:italic>p<\/jats:italic>\n                      &gt; 0.99) in post\u2010operative complication rates between the conventional TKA and RA TKA groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The introduction of the RA TKA system was associated with a learning curve for operative time of 8.7 cases. Operative times between the RA TKA and conventional TKA group were similar. The short learning curve implies this RA TKA system can be adopted relatively quickly into a surgical team with minimal risks to patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40634-022-00524-5","type":"journal-article","created":{"date-parts":[[2022,8,30]],"date-time":"2022-08-30T18:11:46Z","timestamp":1661883106000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Introduction of ROSA robotic\u2010arm system for total knee arthroplasty is associated with a minimal learning curve for operative time"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0197-307X","authenticated-orcid":false,"given":"Scott M.","family":"Bolam","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Auckland City Hospital Auckland New Zealand"},{"name":"Department of Surgery Faculty of Medical and Health Sciences University of Auckland Building 502 20185\u00a0Park Road, Grafton 1023 Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei Lin","family":"Tay","sequence":"additional","affiliation":[{"name":"Department of Surgery Faculty of Medical and Health Sciences University of Auckland Building 502 20185\u00a0Park Road, Grafton 1023 Auckland New Zealand"},{"name":"Department of Orthopaedic Surgery North Shore Hospital Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faseeh","family":"Zaidi","sequence":"additional","affiliation":[{"name":"Department of Surgery Faculty of Medical and Health Sciences University of Auckland Building 502 20185\u00a0Park Road, Grafton 1023 Auckland New Zealand"},{"name":"Auckland Bioengineering Institute University of Auckland Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghavendra P.","family":"Sidaginamale","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics University Hospital of North Tees Stockton on Tees United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hanlon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Auckland City Hospital Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob T.","family":"Munro","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Auckland City Hospital Auckland New Zealand"},{"name":"Department of Surgery Faculty of Medical and Health Sciences University of Auckland Building 502 20185\u00a0Park Road, Grafton 1023 Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Paul","family":"Monk","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Auckland City Hospital Auckland New Zealand"},{"name":"Department of Surgery Faculty of Medical and Health Sciences University of Auckland Building 502 20185\u00a0Park Road, Grafton 1023 Auckland New Zealand"},{"name":"Auckland Bioengineering Institute University of Auckland Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,30]]},"reference":[{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.artd.2021.10.020"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402\u2010021\u201004048\u2010y"},{"key":"e_1_2_10_4_2","first-page":"7","article-title":"COVID\u201019, 20, 21: lessons from New Zealand's 2020 response for 2021 and beyond","volume":"134","author":"Bloomfield A","year":"2021","journal-title":"N Z Med J"},{"key":"e_1_2_10_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000001324"},{"key":"e_1_2_10_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010009\u20101119\u20109"},{"key":"e_1_2_10_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000092983.12414.e9"},{"key":"e_1_2_10_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(11)60752\u20106"},{"key":"e_1_2_10_9_2","doi-asserted-by":"publisher","DOI":"10.1201\/9781584889830"},{"key":"e_1_2_10_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010018\u20105138\u20105"},{"key":"e_1_2_10_11_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.100B8.BJJ\u20102018\u20100040.R1"},{"key":"e_1_2_10_12_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.100B7.BJJ\u20102017\u20101449.R1"},{"key":"e_1_2_10_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000000916"},{"key":"e_1_2_10_14_2","first-page":"1522","article-title":"Optimizing total knee arthroplasty with ROSA\u00ae robotic technology","volume":"40","author":"Knapp PW","year":"2022","journal-title":"Surg Technol Online"},{"key":"e_1_2_10_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010016\u20104732\u20104"},{"key":"e_1_2_10_16_2","first-page":"1","article-title":"Clinical outcome before and after COVID\u201019 quarantine in patients affect of knee and hip osteoarthritis: Experience of orthopedic department in one of the first European country involved in COVID\u201019 pandemic","volume":"91","author":"Larghi MM","year":"2020","journal-title":"Acta Biomed"},{"key":"e_1_2_10_17_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102474\u201013\u2010250"},{"key":"e_1_2_10_18_2","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100040\u20101715571"},{"key":"e_1_2_10_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010021\u201006452\u20108"},{"key":"e_1_2_10_20_2","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100040\u20101715126"},{"key":"e_1_2_10_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jor.2019.03.010"},{"key":"e_1_2_10_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2019.06.040"},{"key":"e_1_2_10_23_2","first-page":"1","article-title":"High accuracy of a new robotically assisted technique for total knee arthroplasty: an in vivo study","volume":"4","author":"Rossi SMP","year":"2022","journal-title":"Knee Surg, Sport Traumatol Arthrosc"},{"key":"e_1_2_10_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2013.01.012"},{"key":"e_1_2_10_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2005.08.024"},{"issue":"20","key":"e_1_2_10_26_2","first-page":"00091","article-title":"Periprosthetic fractures through tracking pin sites following computer navigated and robotic total and unicompartmental knee arthroplasty: A systematic review","volume":"9","author":"Smith TJ","year":"2021","journal-title":"JBJS Rev"},{"key":"e_1_2_10_27_2","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100037\u20101608809"},{"key":"e_1_2_10_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010012\u20102407\u20103"},{"key":"e_1_2_10_29_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402\u2010021\u201004044\u20102"},{"key":"e_1_2_10_30_2","doi-asserted-by":"crossref","unstructured":"TayML CarterM BolamSM ZengN YoungSW(2022) Robotic\u2010arm assisted unicompartmental knee arthroplasty system has a learning curve of 11 cases and increased operating time. 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These affiliations did not influence study design or data collection, analysis, or interpretation of data. Zimmer Biomet did not influence any decisions for manuscript preparation or publication. All other authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"86"}}