Learning curve of the VELYS robotic-assisted total knee arthroplasty system

Abstract

Background: The rate of total knee arthroplasty (TKA) being performed is rapidly rising and the demand for safe, effective, and efficient techniques has never been more paramount. With the promise of enhanced precision and personalization of technique robotic-assisted surgery has emerged as an enticing option for knee arthroplasty surgery. This study analyzes one surgeon’s learning curve for an imageless, table-mounted robotic-assisted TKA platform to determine clinical integration implications. Methods: This prospective observational study enrolled twenty-five patients undergoing robotic-assisted TKA. Pertinent preoperative demographics, postoperative recovery metrics, and intraoperative data were collected. To observe potential relationships and define the learning curve, operative stages were evaluated using two-sided cumulative sum (CUSUM) charts. Results: The CUSUM analysis identified that surgical proficiency occurred after five cases, with the learning period concluding between four and seven cases by stage. No significant differences in demographics were found between the learning and proficient cases. Comparative recovery metrics between phases demonstrated trends toward shorter hospital stays and reduced opioid use in the proficient phase, though these differences were not statistically significant. KOOS JR scores were similar across both phases at all time points, with no significant differences observed. No readmissions were reported within 30 or 90 days, and no reoperations have been reported postoperatively. Conclusions: This study demonstrates that the imageless, table-mounted robotic-assisted TKA platform is a viable option when considering robotic-assisted techniques and requires a learning curve of five cases to fluently integrate the device into a surgeon’s TKA operative workflow.