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.

scholarly journals Learning of A CAOS Enhanced Mechanical Instrument System for Total Knee Arthroplasty: A CUSUM Analysis

10.29007/k12h ◽  
2018 ◽  
Author(s):  
Yifei Dai ◽  
James Huddleston ◽  
Matt Rueff ◽  
Laurent Angibaud ◽  
Derek Amanatullah
Keyword(s):  
Orthopaedic Surgery ◽  
Computer Assisted ◽  
Surgical Time ◽  
Experience Levels ◽  
Computer Assisted Orthopaedic Surgery ◽  
Cusum Analysis ◽  
Total Knee ◽  
Conventional Instrument ◽  
Cumulative Sum Control ◽  
Case Number

This study employed an advanced method (Cumulative sum control chart, CUSUM) to analyze the learning curve regarding surgical efficiency (time) in four surgeons from different experience levels upon their adoption of a mechanical instrument enhanced by computer-assisted orthopaedic surgery (CAOS). The first six CAOS-TKA cases of each surgeon were analyzed to identify the case number when their learning process was stabilized (cases to proficiency). The surgical time increase during the learning phase were compared between senior and fellow surgeons. The data demonstrated a short learning duration (2-3 cases) both senior and fellow surgeons and a mild impact from learning compared to cases performed using conventional instrument system.

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 Relationship between cutting errors and learning curve in computer-assisted total knee replacement

2009 ◽  
Vol 34 (5) ◽  
pp. 655-662 ◽  
Author(s):  
Alfonso Manzotti ◽  
Pietro Cerveri ◽  
Elena De Momi ◽  
Chris Pullen ◽  
Norberto Confalonieri
Keyword(s):  
Total Knee Replacement ◽  
Learning Curve ◽  
Knee Replacement ◽  
Computer Assisted ◽  
Total Knee

scholarly journals 845 Flattening the Learning Curve: The Evaluation of Extended Laparoscopic Simulation Training for Novice Surgeons

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S A Joiya ◽  
M Hamid ◽  
Z Siddiqui
Keyword(s):  
Learning Curve ◽  
Skill Acquisition ◽  
Postoperative Recovery ◽  
Task Completion ◽  
Complication Rates ◽  
Novice Group ◽  
Surgical Trainees ◽  
Long Duration ◽  
Hospital Stays ◽  
Novice Surgeons

Abstract Introduction Associated with faster postoperative recovery, reduced length of hospital stays and scarring; laparoscopy has become the favoured approach for many surgical procedures across a range of specialties. However, due to its challenging learning curve, it has also been associated with increased theatre time and higher complication rates. Method A prospective, observational study with box trainers was carried out by novice medical students and trainees to evaluate the efficacy of long duration courses on skill acquisition. The novice group undertook a 5-week curriculum composed of lectures, demonstrations and spaced timed-assessments involving 3 tasks: hoop placement, stacking of sugar cubes and surgical cutting. Results Time taken for novice participants to complete a task individually and collectively improved markedly from the first to the third attempt, with an overall 44% reduction in time observed over the 5-weeks. We invited back 6 novice participants and 6 core surgical trainees after 4-weeks to complete the same tests. There was a further 18% time improvement in the novice group, with 44% faster task completion. Conclusions Given the success of this study and other simulation courses reported in the literature, we recommend more courses adopt a spaced-out approach; and a simulation curriculum for surgical trainees to cultivate greater skill acquisition.

scholarly journals Robotic-arm assisted total knee arthroplasty is associated with improved accuracy and patient reported outcomes: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Junren Zhang ◽  
Wofhatwa Solomon Ndou ◽  
Nathan Ng ◽  
Paul Gaston ◽  
Philip M. Simpson ◽  
...  
Keyword(s):  
Learning Curve ◽  
Functional Outcomes ◽  
Patient Reported Outcomes ◽  
Meta Analysis ◽  
Robotic Arm ◽  
Component Position ◽  
Positioning Accuracy ◽  
Patient Reported ◽  
Total Knee ◽  
Improved Accuracy

AbstractThis systematic review and meta-analysis were conducted to compare the accuracy of component positioning, alignment and balancing techniques employed, patient-reported outcomes, and complications of robotic-arm assisted total knee arthroplasty (RATKA) with manual TKA (mTKA) and the associated learning curve. Searches of PubMed, Medline and Google Scholar were performed in October 2020 using PRISMA guidelines. Search terms included “robotic”, “knee” and “arthroplasty”. The criteria for inclusion were published clinical research articles reporting the learning curve for RATKA and those comparing the component position accuracy, alignment and balancing techniques, functional outcomes, or complications with mTKA. There were 198 articles identified, following full text screening, 16 studies satisfied the inclusion criteria and reported the learning curve of rTKA (n=5), component positioning accuracy (n=6), alignment and balancing techniques (n=7), functional outcomes (n=7), or complications (n=5). Two studies reported the learning curve using CUSUM analysis to establish an inflexion point for proficiency which ranged from 7 to 11 cases and there was no learning curve for component positioning accuracy. The meta-analysis showed a significantly lower difference between planned component position and implanted component position, and the spread was narrower for RATKA compared with the mTKA group (Femur coronal: mean 1.31, 95% confidence interval (CI) 1.08–1.55, p<0.00001; Tibia coronal: mean 1.56, 95% CI 1.32–1.81, p<0.00001). Three studies reported using different alignment and balancing techniques between mTKA and RATKA, two studies used the same for both group and two studies did not state the methods used in their RATKA groups. RATKA resulted in better Knee Society Score compared to mTKA in the short-to-mid-term follow up (95%CI [− 1.23,  − 0.51], p=0.004). There was no difference in arthrofibrosis, superficial and deep infection, wound dehiscence, or overall complication rates. RATKA demonstrated improved accuracy of component positioning and patient-reported outcomes. The learning curve of RATKA for operating time was between 7 and 11 cases. Future well-powered studies on RATKAs should report on the knee alignment and balancing techniques utilised to enable better comparisons on which techniques maximise patient outcomes.Level of evidence III.

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