Evidence map›Paper›PMID 36836448›Full record

ArticleJournal of personalized medicine2023

Digital TKA Alignment Training with a New Digital Simulation Tool (Knee-CAT) Improves Process Quality, Efficiency, and Confidence.

Heiko Graichen, Marco Strauch, Michael T Hirschmann, Roland Becker, Sébastien Lustig, Mark Clatworthy, Jacobus Daniel Jordaan, Kaushik Hazratwala, Rüdiger von Eisenhart-Rothe, Karlmeinrad Giesinger and 1 more

Open access · goldAbstract read
In one paragraph

Article in Journal of personalized medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.3field-weighted citation impact, top 22% of its field
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

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Trial
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

11 authors at 8 institutions in 5 countries.

Heiko GraichenDepartment of Arthroplasty, General Orthopaedics and Sports Medicine, Asklepios Orthopaedic Hospital Lindenlohe, 92421 Schwandorf, Germany.ORCID 0000-0001-6095-3186
Marco StrauchDepartment of Arthroplasty, General Orthopaedics and Sports Medicine, Asklepios Orthopaedic Hospital Lindenlohe, 92421 Schwandorf, Germany.
Michael T HirschmannDepartment of Orthopedic Surgery and Traumatology, Kantonsspital Baselland, University Hospital of Basel, 4101 Bruderholz, Switzerland.ORCID 0000-0002-4014-424X
Roland BeckerDepartment of Orthopaedic and Traumatology, Centre of Joint Arthroplasty West-Brandenburg, University of Brandenburg, 14770 Brandenburg, Germany.
Sébastien LustigDepartment of Orthopaedic Surgery and Sports Medicine, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Lyon University Hospital, 69004 Lyon, France.
Mark ClatworthyDepartment of Orthopaedics, Ascot Hospital, Remuera, Auckland 3050, New Zealand.
Jacobus Daniel JordaanDivision of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences Stellenbosch University, Tygerberg 7505, South Africa.ORCID 0000-0002-6150-9463
Kaushik HazratwalaQueensland Lower Limb Clinic, Mater Medical Center, Pimlico, QLD 4812, Australia.ORCID 0000-0002-0649-9231
Rüdiger von Eisenhart-RotheDepartment of Orthopedics and Sports Orthopedics, Klinikum Rechts der Isar, Technical University Munich, 81675 München, Germany.
Karlmeinrad GiesingerDepartment of Orthopaedics and Traumatology, Kantonsspital St. Gallen, 9000 St. Gallen, Switzerland.
Tilman CalliessArticon Spezialpraxis für Gelenkchirurgie, Salem-Spital, 3013 Bern, Switzerland.
Asklepios Orthopädische Klinik Lindenlohe · DEHirslanden Salem-Spital · CHKantonsspital St. Gallen · CHMater Health Services · AUStellenbosch University · ZATUM Klinikum · DEUniversité Claude Bernard Lyon 1 · FRUniversity Hospital of Basel · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Individual alignment techniques have been introduced to restore patients' unique anatomical variations during total knee arthroplasty. The transition from conventional mechanical alignment to individualised approaches, with the assistance of computer and/or robotic technologies, is challenging. The objective of this study was to develop a digital training platform with real patient data to educate and simulate various modern alignment philosophies. The aim was to evaluate the training effect of the tool by measuring the process quality and efficiency, as well as the post-training surgeon's confidence with new alignment philosophies. Based on 1000 data sets, a web-based interactive TKA computer navigation simulator (Knee-CAT) was developed. Quantitative decisions on bone cuts were linked to the extension and flexion gap values. Eleven different alignment workflows were introduced. A fully automatic evaluation system for each workflow, with a comparison function for all workflows, was implemented to increase the learning effect. The results of 40 surgeons with different experience levels using the platform were assessed. Initial data were analysed regarding process quality and efficiency and compared after two training courses. Process quality measured by the percentage of correct decisions was increased by the two training courses from 45% to 87.5%. The main reasons for failure were wrong decisions on the joint line, tibia slope, femoral rotation, and gap balancing. Efficiency was obtained with a reduction in time spent per exercise from 4 min 28 s to 2 min 35 s (42%) after the training courses. All volunteers rated the training tool as helpful or extremely helpful for learning new alignment philosophies. Separating the learning experience from OR performance was mentioned as one of the main advantages. A novel digital simulation tool for the case-based learning of various alignment philosophies in TKA surgery was developed and introduced. The simulation tool, together with the training courses, improved surgeon confidence and their ability to learn new alignment techniques in a stress-free out-of-theatre environment and to become more time efficient in making correct alignment decisions.

Indexed as

alignmentcomputer assistanceroboticssimulatorteaching tooltotal knee arthroplasty

Identifiers

PMID36836448
PMCPMC9960184
OpenAlexW4318199985

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.