Evidence map›Paper›PMID 35226121›Full record

ArticleArchives of orthopaedic and trauma surgery2023

The learning curve associated with imageless navigation in total knee arthroplasty.

Michelle A Zabat, Christian T Oakley, Scott E Marwin, Morteza Meftah, Ran Schwarzkopf

Abstract read
In one paragraph

Article in Archives of orthopaedic and trauma surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Michelle A ZabatDepartment of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, NYU Langone Health, 301 East 17th Street, New York, NY, 10003, USA.ORCID http://orcid.org/0000-0001-7121-9219
Christian T OakleyDepartment of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, NYU Langone Health, 301 East 17th Street, New York, NY, 10003, USA.
Scott E MarwinDepartment of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, NYU Langone Health, 301 East 17th Street, New York, NY, 10003, USA.
Morteza MeftahDepartment of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, NYU Langone Health, 301 East 17th Street, New York, NY, 10003, USA.
Ran SchwarzkopfDepartment of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, NYU Langone Health, 301 East 17th Street, New York, NY, 10003, USA. Ran.Schwarzkopf@nyulangone.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionComputer-assisted navigation systems (CAS) are increasingly being integrated into total knee arthroplasty (TKA) procedures, but perceptions of associated learning curve and increased operative time continue to curtail uptake. Newer-generation navigational systems aim to streamline integration into surgical workflow to mitigate increases in operative time. Here, we assess the impact of a novel imageless CAS on operative time for TKA.

methodsA retrospective analysis of prospectively collected data of a cohort of patients undergoing primary unilateral TKA with one of three surgeons between October 2019 and March 2020 was conducted. Consecutive cases using a novel imageless CAS were included in analysis. For each surgeon, average operative time was recorded and compared in sequential five-case cohorts to average operative time for the same procedure performed conventionally using a two-tailed t test.

resultsAverage conventional operative times were 95.9 ± 15.0, 86.6 ± 13.7, and 116.9 ± 25.1 min for the three surgeons. Initial CAS-assisted operative times increased to 107.0 ± 9.8 (p = 0.07) and 102.4 ± 13.2 (p = 0.06) min for Surgeons 1 and 2 and decreased to 113.2 ± 9.8 min (p = 0.52) for Surgeon 3. Most recent CAS-assisted operative times were 94.8 ± 13.9 (p = 0.88), 88.7 ± 15.3 (p = 0.84), and 104.8 ± 13.2 (p = 0.12) min as compared to pre-CAS. Absolute differences for the most recent navigated procedures ranged from 12.1 min faster to 2.0 min slower.

conclusionThe learning curve for TKA navigation may be as few as 10 cases, and any associated increases in operative time may be transient and non-significant. Moreover, navigation may ultimately speed operative time, perhaps as the result of enhanced intraoperative assessment of alignment.

Indexed as

Arthroplasty, Replacement, KneeSurgery, Computer-AssistedHumansKnee JointLearning CurveOperative TimeRetrospective StudiesComputer-assisted navigationNavigated TKAPatient reported outcomes

Identifiers

PMID35226121
PMCPMC8883460

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.