Evidence map›Paper›PMID 40781202›Full record

ReviewJournal of robotic surgery2025

Impact of robotic total hip and knee arthroplasty on resident and fellow training in orthopedic surgery.

Shujaa T Khan, Benjamin E Jevnikar, Ahmed K Emara, Peter G Delaney, Khaled A Elmenawi, Peter A Surace, Nicolas S Piuzzi, Matthew Deren

Abstract readReview
In one paragraph

Review in Journal of robotic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

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

2 citing papers in PubMed.

  1. Article
  2. Article
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

8 authors.

Shujaa T KhanDepartment of Orthopedic Surgery, Cleveland Clinic Foundation, Orthopedic and Rheumatology Institute, 9500 Euclid Ave, A41, Cleveland, OH, 44195, USA.
Benjamin E JevnikarDepartment of Orthopedic Surgery, Cleveland Clinic Foundation, Orthopedic and Rheumatology Institute, 9500 Euclid Ave, A41, Cleveland, OH, 44195, USA.
Ahmed K EmaraDepartment of Orthopedic Surgery, Cleveland Clinic Foundation, Orthopedic and Rheumatology Institute, 9500 Euclid Ave, A41, Cleveland, OH, 44195, USA.
Peter G DelaneyDepartment of Orthopedic Surgery, Cleveland Clinic Foundation, Orthopedic and Rheumatology Institute, 9500 Euclid Ave, A41, Cleveland, OH, 44195, USA.
Khaled A ElmenawiDepartment of Orthopedic Surgery, Cleveland Clinic Foundation, Orthopedic and Rheumatology Institute, 9500 Euclid Ave, A41, Cleveland, OH, 44195, USA.
Peter A SuraceDepartment of Orthopedic Surgery, Cleveland Clinic Foundation, Orthopedic and Rheumatology Institute, 9500 Euclid Ave, A41, Cleveland, OH, 44195, USA.
Nicolas S PiuzziDepartment of Orthopedic Surgery, Cleveland Clinic Foundation, Orthopedic and Rheumatology Institute, 9500 Euclid Ave, A41, Cleveland, OH, 44195, USA. piuzzin@ccf.org.
Matthew DerenDepartment of Orthopedic Surgery, Cleveland Clinic Foundation, Orthopedic and Rheumatology Institute, 9500 Euclid Ave, A41, Cleveland, OH, 44195, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Robotic-assisted total joint arthroplasty (RA-TJA) has experienced rapid growth in adoption and is reshaping orthopedic surgical practice. Despite offering potential for improved precision, reproducibility, and intraoperative feedback, its integration into orthopedic training has raised questions about educational equity and quality, manual skill development, and trainee autonomy. This review examines the educational implications of RA-TJA on orthopedic residency and fellowship training. The goal is to synthesize existing literature on RA-TJA impact on technical skill acquisition, surgical exposure, operative autonomy, and cognitive engagement, with attention to global disparities and the role of simulation in modern training models. A narrative literature review was conducted, focusing on empirical studies, trainee surveys, and expert opinion related to robotic systems in arthroplasty education. Specific attention was given to competency-based medical education (CBME) frameworks, intraoperative performance metrics, simulation-based learning, and institutional variability. Robotic systems facilitate early technical proficiency by offering structured intraoperative workflows and objective metrics, aligning well with CBME. These platforms enhance resident involvement in preoperative planning and spatial understanding but may inadvertently reduce manual versatility and intraoperative decision-making without complementary training in conventional techniques. Trainee autonomy varies significantly by institution, and access to RA-TJA during post-graduate medical education remains inconsistent. Simulation technologies, particularly virtual reality, represent scalable solutions to bridge training gaps but require standardized integration, assessment models, and certification pathways. RA-TJA presents both opportunities and challenges for orthopedic education. Its successful implementation requires deliberate curricular design, hybrid exposure to both robotic and manual techniques, and equitable access to simulation-based resources. Moving forward, training standardization, integration of performance-based progression metrics, and global cooperation will be essential to preparing orthopedic surgeons for the evolving digital surgical landscape.

Indexed as

Arthroplasty, Replacement, HipArthroplasty, Replacement, KneeInternship and ResidencyOrthopedicsRobotic Surgical ProceduresClinical CompetenceEducation, Medical, GraduateFellowships and ScholarshipsHumansarthroplastyeducationreplacementresidentrobottraining

Identifiers

PMID40781202
PMCPMC12334456

What OpenQuestion holds

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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.