LEARNING CURVE OF EXPERIENCED SURGEON AND EARLY RESULTS OF THE CORI ROBOTIC SYSTEM IN KNEE REPLACEMENT

Introduction. Knee arthroplasty is the method of choice in the treatment of late stages of gonarthrosis. A new stage in the development of technologies in orthopedics is associated with the introduction of robotic systems into the practice of orthopedic surgeons. The aim of the study : to evaluate the learning curve and compare early outcomes of knee replacement using the CORI robotic system with manual joint replacement. Materials and methods . The prospective study involved 30 patients (11 men, 19 women), who were randomized into two groups using a random number generator: Group 1 (n = 15), patients underwent robotic knee arthroplasty using the CORI system from Smith&nephew; Group 2 (n = 15), patients underwent manual knee arthroplasty. Evaluation of the functional state of the knee joint in the postoperative period was also carried out using the KSS questionnaire. Results . Analysis of the learning curve of a surgeon with experience in using other robotic systems showed that starting from the 3rd case, the duration of the operation began to decrease and reached a plateau from the 6th case of using the CORI robotic system. In group №1, the duration of the operation was statistically significantly longer compared to group №2. The volume of intraoperative blood loss was comparable in both groups. The KSS values were statistically significantly higher in group №1. Discussion . The authors suggest that the main reason for the higher KSS scores in group №1 is the minimal soft tissue release, which in this study was achieved using the functional alignment approach. Conclusion. The data obtained during the study indicate that the existing experience in using robotic systems contributes to a faster mastery of the robot-assisted CORI system. In our opinion, a surgeon with experience in working with a robotic system can overcome the learning curve and reach a plateau already at the 6th case of knee arthroplasty. Moreover, the duration of the operation using the robotic system after overcoming the learning curve was longer, compared to the manual technique.