Early clinical outcomes and learning curve study of robot- assisted precision osteotomy in total knee arthroplasty in the context of ERAS

Abstract Objective: To compare the early clinical outcomes of robot-assisted total knee arthroplasty (RA-TKA) with conventional manual total knee arthroplasty (CM-TKA) and analyze their learning curves. Methods: Patients who underwent initial unilateral total knee arthroplasty for osteoarthritis of the knee in Panzhihua Central Hospital from June to November 2023 were included. 130 patients were randomly divided into two groups: group A underwent total knee arthroplasty with HURWA Orthopaedic System (65 cases), and group B patients were performed using conventional tools (65 cases). Basic data, surgical information, imaging data and postoperative function were compared between the two groups. Surgical time was analyzed by cumulative sum analysis method (CUSUM), and the goodness of fit was judged by R². Results: Baseline data were consistent between the two groups, the FFC of the patients in group A was closer to 90° than group B, the LTC was concentrated at 87° and HKA was concentrated at 180°. There was no significant difference in inflammatory indicators and perioperative blood loss. Respectively, 7.80% (groups A) vs 9.52% (groups B) of the patients developed lower extremity intermuscular venous thrombosis, but there was no difference in knee function, pain and satisfaction.The operation time of group A was about 11.3 min longer than group B. The learning curve was best fitted as a cubic curve, and the fitted curve reached its apex when the number of surgical cases accumulated to the 22nd case. During the whole learning curve, no surgical termination or accidental injury caused by the failure of the robotic system occurred, and none of them suffered from serious complications such as infections, periprosthetic fracture, cardiac and cerebral vascular accidents, and so on. Conclusion: HURWA robot-assisted TKA with learning curve fixation in about 22 cases can obtain good lower limb force line reconstruction and precise implantation of prosthesis, which is a safe and effective surgical procedure for osteoarthritis of the knee.