ArticleArchives of orthopaedic and trauma surgery2021
Imageless robotic handpiece-assisted total knee arthroplasty: a learning curve analysis of surgical time and alignment accuracy.
Article in Archives of orthopaedic and trauma surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 6 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
41 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Platform-Specific Learning Curves in Robotic-Assisted Total Knee Arthroplasty: A Systematic Review.Orthopaedic surgery · 2026Pooled it
- The learning curve of robotic-assisted total knee arthroplasty: a systematic review and meta-analysis.Journal of robotic surgery · 2025Pooled it
- Learning curve of robotic-assisted total knee arthroplasty: a literature review.Journal of robotic surgery · 2025Pooled it
- Systematic review and meta-analysis of economic and healthcare resource utilization outcomes for robotic versus manual total knee arthroplasty.Journal of robotic surgery · 2023Pooled it
- The evolution of robotic systems for total knee arthroplasty, each system must be assessed for its own value: a systematic review of clinical evidence and meta-analysis.Archives of orthopaedic and trauma surgery · 2023Pooled it
- Complications and downsides of the robotic total knee arthroplasty: a systematic review.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Pooled it
- Improved accuracy of implant placement with an imageless handheld robotic system compared to conventional instrumentation in patients undergoing total knee arthroplasty: a prospective randomized controlled trial using CT-based assessment of radiological outcomes.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Trial
- Robotic-Assisted Total Knee Arthroplasty Utilizing NAVIO, CORI Imageless Systems and Manual TKA Accurately Restore Femoral Rotational Alignment and Yield Satisfactory Clinical Outcomes: A Randomized Controlled Trial.Medicina (Kaunas, Lithuania) · 2023Trial
- Time neutrality and reduced ecological burden - handheld robotic-assisted total knee arthroplasty improves operating room efficiency compared with manual total knee arthroplasty.International orthopaedics · 2026Article
- Robotic-assisted total knee arthroplasty: radiological precision, clinical outcomes, and benchmarks for emerging systems.Journal of robotic surgery · 2026Review
- Learning curve in image-based robotic assisted total knee arthroplasty: a MAKO-robot experience.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Observational
- Learning curve for robotic-assisted total knee arthroplasty.Journal of orthopaedic surgery and research · 2026Article
- Does Resident Rotation Affect the Learning Curve of Active Robotic TKA? A Study of Surgical Efficiency and Radiographic Precision.Medicina (Kaunas, Lithuania) · 2026Article
- Efficacy study of robot-assisted total knee arthroplasty in patients with different levels of medical experience.Journal of robotic surgery · 2026Article
- [Robotics in knee arthroplasty : Current status and developments].Orthopadie (Heidelberg, Germany) · 2026Review
- VELYS robotic-assisted total knee replacement leads to improved mobility, reduction in hospitalisation, surgical duration, and better psychological outcomes: a propensity score matched analysis.Arthroplasty (London, England) · 2025Article
- Accuracy and learning curve of imageless robotic-assisted total knee arthroplasty.Journal of orthopaedics · 2025Article
- The role of next-generation robotic systems in transforming knee arthroplasty: precision and beyond.Journal of robotic surgery · 2025Review
- Evaluation of the learning curve in robot-assisted knee arthroplasty: A Systematic review.Journal of experimental orthopaedics · 2025Review
- Handheld imageless robotic total knee arthroplasty improves accuracy and early clinical outcomes when compared with navigation.Arthroplasty (London, England) · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionRobotic-assisted surgery techniques are increasing in total knee arthroplasty (TKA). One crucial point is the prolonged time of surgery. The primary objective of this study was to determine the learning curve necessary to minimize the time of surgery. The secondary objective was to evaluate the accuracy of the implant alignment when using an imageless robotic system for TKA. MATERIALS AND
methodsIn a case-control study, the first 70 consecutive robotic-assisted TKA procedures performed by a single senior surgeon were analyzed with regard to surgery time and implant alignment by comparing the intraoperative plan with the postoperative alignment. The evaluation of the learning curve with respect to surgery time was conducted using cumulative summation (CUSUM) analysis. The joint line height was measured with a new technique. Surgery time and joint line reconstruction were compared to 70 consecutive conventional TKA procedures.
resultsThe learning curve for robotic TKA was completed after 11 cases. The learning curve did not influence the accuracy of joint line obliquity, joint line height, or limb alignment. The intraoperative plan designed for the robotic system was precisely implemented. The mean skin-to-skin time in the robotic group after the learning curve was completed did not differ from that in the manual group. A significant positive correlation was observed between the preoperative hip-knee-ankle angle and the postoperative distalization of the joint line in the robotic-assisted TKA group.
conclusionAfter completing the initial learning curve of 11 cases, the surgery time required to perform imageless robotic handpiece-assisted TKA was similar to that for the conventional technique. However, no learning curve was observed for the implant positioning when using the imageless robotic system. The implementation of the intraoperative plan was accurate up to < 2°. The precision of the system allows the implementation of different joint balancing approaches between valgus and varus morphotypes.
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