Abstract
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. 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. Mean operation length was 59.4 ± 7.4min 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 (3.8min in group 1 versus 1.2min in group 4, p < 0.005), ten cases for registration time (5.2min in group 1 versus 3.8 in group 2, p = 0.039) and ten cases for tibial cutting time (1.6min 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. 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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