scholarly journals Application-Specific Learning Curve in Computer-Assisted Total Knee Arthroplasty

10.29007/nrzj ◽  
2020 ◽  
Author(s):  
Yifei Dai ◽  
Laurent Angibaud ◽  
Guillaume Bras ◽  
Cyril Hamad ◽  
Jefferson Craig Morrison
Keyword(s):  
Learning Curve ◽  
Learning Process ◽  
Computer Assisted ◽  
Surgical Time ◽  
Experience Level ◽  
Total Knee ◽  
The Impact ◽  
Application Specific ◽  
Different Levels ◽  
Specific Learning

This study employed an advanced method (CUSUM) to analyze the learning curve regarding surgical efficiency (time) using two CAOS applications, which were designed to address user needs with different levels of comprehensiveness in term of offered guidance and instrumentation requirements. Two group of surgeons, each used either CAOS applications were included in the study. The first 50 CAOS TKA cases from each surgeon were analyzed to identify the learning curve. The duration of learning, as well as the impact of learning based on surgical time, were assessed with regard to the specific CAOS application and surgeon’s previous CAOS experience level. The data demonstrated differences in term of pattern of adoption during learning process between the two CAOS applications. However, the learning process was not sensitive to surgeon’s experience level.

scholarly journals CAOS Augmented Mechanical Instrumentation Provides Versatility and Improved Accuracy During Total Knee Arthroplasty

10.29007/mq2k ◽  
2020 ◽  
Author(s):  
Jefferson Craig Morrison ◽  
Erika Frazier ◽  
Mary Denton Stumb
Keyword(s):  
Total Knee Arthroplasty ◽  
Length Of Stay ◽  
Knee Arthroplasty ◽  
Weight Bearing ◽  
Computer Assisted ◽  
Surgical Time ◽  
Surgical Workflow ◽  
Leg Alignment ◽  
Total Knee ◽  
The Impact

This study assessed the impact of adding computer-assisted orthopedic surgery (CAOS) augmentation to conventional mechanical instrumentation with regard to the enablement of both mechanical and natural alignment surgical philosophies and accuracy of postoperative alignment for total knee arthroplasty (TKA). Fifty CAOS augmented TKA cases were compared to 101 conventional cases. Data on surgical time, length of stay, and postoperative weight-bearing long leg alignment were collected. The results reported no significant impact on surgical time with incorporation of CAOS augmentation into the conventional surgical workflow, as well as a shorter length of stay and substantial decrease in alignment outliers compared to the conventional TKA cases. The study revealed the advantages of CAOS augmentation in providing a non-disruptive tool to enhance surgical accuracy and offer versatility in accommodating different surgical philosophies during TKA.

scholarly journals Learning Curve in Computer-Assisted Total Knee Arthroplasty: A CUSUM Analysis

10.29007/wzh3 ◽  
2018 ◽  
Author(s):  
Yifei Dai ◽  
Guillaume Bras ◽  
Cyril Hamad
Keyword(s):  
Learning Curve ◽  
Learning Process ◽  
High Sensitivity ◽  
Computer Assisted ◽  
Time Increase ◽  
Experience Levels ◽  
Cusum Analysis ◽  
Total Knee ◽  
Novice Surgeons ◽  
Case Number

This study employed an advanced method (CUSUM) to analyze the learning curve regarding surgical efficiency (time) in 10 surgeons from different experience levels upon their adoption of a contemporary CAOS TKA system. The first 50 CAOS TKA cases of each surgeon were analyzed to identify the case number when their learning process was stabilized (cases of proficiency). The surgical time increase during the learning phase were compared between senior and novice surgeons. The data demonstrated a short learning duration (12-13 cases) and a moderate learning process (~15min time increase compared to later cases) upon adoption of the CAOS system, without high sensitivity to surgeon’s experience level.

Application-Specific Learning Curve With a Modern Computer-Assisted Orthopedic Surgery System for Joint Arthroplasty

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yifei Dai ◽  
Sharat Kusuma ◽  
Alexander T. Greene ◽  
Wen Fan ◽  
Amaury Jung ◽  
...  
Keyword(s):  
Learning Curve ◽  
Orthopedic Surgery ◽  
Total Shoulder Arthroplasty ◽  
Computer Assisted ◽  
Learning Approaches ◽  
Surgical Time ◽  
Modern Computer ◽  
Cusum Method ◽  
Computer Assisted Orthopedic Surgery ◽  
Specific Learning

Abstract A commonly acknowledged barrier for the adoption of new computer-assisted orthopedic surgery (CAOS) technologies relates to a perceived long and steep learning curve. However, this perception has not been objectively tested with the consideration of surgeon-specific learning approaches. This study employed the cumulative sum control chart (CUSUM) to investigate individual surgeon's learning of CAOS technology by monitoring the stability of the surgical process regarding surgical time. Two applications for total knee arthroplasty (TKA) and two applications for total shoulder arthroplasty (TSA) provided by a modern CAOS system were assessed with a total of 21 surgeons with different levels of previous CAOS experience. The surgeon-specific learning durations identified by CUSUM method revealed that CAOS applications with “full guidance” (i.e., those that offer comprehensive guidance, full customization, and utilize CAOS-specific instrumentation) required on average less than ten cases to learn, while the streamlined application designed as a CAOS augmentation of existing mechanical instrumentation demonstrated a minimal learning curve (less than three cases). During the learning phase, the increase in surgical time was found to be moderate (approximately 15 min or less) for the “full guidance” applications, while the streamlined CAOS application only saw a clinically negligible time increase (under 5 min). The CUSUM method provided an objective and consistent measurement on learning, and demonstrated, contrary to common perception, a minimal to modest learning curve required by the modern CAOS system studied.

The Learning Curve in Arthroscopic ACL Reconstruction. The impact on the Surgical Time and Postoperative Clinical Results

2018 ◽  
Vol 69 (10) ◽  
pp. 2874-2876
Author(s):  
Teodor Negru ◽  
Stefan Mogos ◽  
Ioan Cristian Stoica
Keyword(s):  
Anterior Cruciate Ligament ◽  
Learning Curve ◽  
Clinical Outcomes ◽  
Positive Impact ◽  
Cruciate Ligament ◽  
Clinical Results ◽  
Single Bundle ◽  
Surgical Time ◽  
Anterior Cruciate ◽  
The Impact

Rupture of the anterior cruciate ligament (ACL) is a common injury. The objective of the current study was to evaluate if the learning curve has an impact on surgical time and postoperative clinical outcomes after anatomic single-bundle anterior cruciate ligament reconstruction (ACLR) using an outside-in tunnel drilling hamstrings technique. The learning curve has a positive impact on surgical time but has no influence on postoperative clinical outcomes at short time follow-up.

scholarly journals The Learning Curve and Alignment Assessment of an Image-Free Handheld Robot in TKA: The First Patient Series in Europe

10.29007/3nl1 ◽  
2019 ◽  
Author(s):  
Peter Bollars ◽  
Anton Boeckxstaens ◽  
Jan Mievis ◽  
Daniel Janssen
Keyword(s):  
Learning Curve ◽  
Limb Alignment ◽  
Surgical Time ◽  
Planning Time ◽  
Technical Errors ◽  
Total Knee ◽  
Patient Series ◽  
The Mean ◽  
Time Planning ◽  
Surgical System

BACKGROUND: The typical goal of TKA is to obtain a neutral mechanical axis of the leg. The NAVIO® Surgical System (Smith & Nephew, Pittsburgh, PA, USA) is aimed at reducing technical errors and outliers. The aim of this study is to assess the surgeons’ learning curve and limb alignment in TKA.METHODS:The first sixty-nine patients who underwent TKA with the NAVIO system by two experienced surgeons were included in this study. Pre- and postoperative mechanical limb alignment and balancing was measured by the NAVIO system. Registration time, planning time and cutting time was monitored preoperatively by the NAVIO™ system. All data was analyzed retrospectively.RESULTS:The mean preoperative mechanical limb alignment was 3.18° varus (SD 4.28°, range 15.08° varus to 4.30° of valgus). The mean intraoperative planned angle was 0.59° varus (SD 0.97°, range 2.50° varus to 0.99° valgus). The mean postoperative alignment was 1.17° varus (SD 1.78°, range 4.52° varus to 4.33° valgus. The mean extra surgical time (EST) for registration and planning decreased from 23.4min (SD 3.7min) to 13.2min (SD 2.0) throughout the learning curve with a range of 10min05sec to 28min19sec.CONCLUSION: The NAVIO robotic system is a valuable tool in assisting total knee arthroplasty. It allows the surgeon to accurately determine optimal implant position for each patient and minimize statistical outliers in alignment.

Adjustable cutting blocks improve alignment and surgical time in computer-assisted total knee replacement

2011 ◽  
Vol 20 (9) ◽  
pp. 1736-1741 ◽  
Author(s):  
Eduardo M. Suero ◽  
Christopher Plaskos ◽  
Peter L. Dixon ◽  
Andrew D. Pearle
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Computer Assisted ◽  
Surgical Time ◽  
Total Knee

scholarly journals Clinical Variability of Landmark Collection in an Imageless Robot-Assisted Total Knee Arthroplasty System

10.29007/4dzm ◽  
2018 ◽  
Author(s):  
Rahul Khare ◽  
Branislav Jaramaz
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Planning Process ◽  
Computer Assisted ◽  
Accurate Identification ◽  
Implant Placement ◽  
Leg Alignment ◽  
Total Knee ◽  
The Impact ◽  
First Time

Use of computer-assisted Total Knee Arthroplasty systems enable more accurate implant placement, better tissue balancing and improved leg alignment. Image-free computer-assisted TKA systems rely on accurate identification of femoral and tibial landmarks to guide the implant planning process. Previously, researchers have studies the variability in collection of these landmark positions and the impact of this variability on the final implant position. Here, for the first time, we present a study assessing the variability of seven landmarks during anonymized clinical cases. Of all the landmarks, we found that there was maximum variability in collection of the femoral anterior notch point.

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