Early Learning Curve in Robotic-Assisted Total Knee Arthroplasty: A Single-Center Experience

<b>Background/Objectives</b>: This study evaluated the learning curve for robotic-assisted total knee arthroplasty (RA TKA) performed by three experienced surgeons, focusing on procedure duration, surgeon satisfaction, and confidence. <b>Methods:</b> A prospective study was conducted with three senior arthroplasty surgeons, each performing 15 RA TKA procedures using the Triathlon Knee System with the Robotic Arm Interactive Orthopedic (RIO) System. Data on preparation, cut-to-suture, and breakdown times were collected. Surgeon anxiety levels were measured preoperatively using the STAI-6 scale, while postoperative satisfaction and confidence were assessed via a questionnaire. Statistical analysis was conducted using GraphPad Prism. <b>Results:</b> Of 50 scheduled surgeries, 45 were completed. The average cut-to-suture time was 1 h 38 min, with significant time reductions in robotic-specific steps as experience increased. Comparing the first five surgeries to the last five, the time for navigation hardware mounting, landmarks registration, femur and tibia registration, and bone preparation decreased by up to 30% (<i>p</i> < 0.001 to <i>p</i> = 0.025). General instrument preparation time decreased by 20% (<i>p</i> = 0.004). Surgeon anxiety levels dropped, indicating increased comfort with the system, while postoperative surveys showed increased satisfaction and confidence. <b>Conclusions:</b> The study demonstrated a substantial learning curve for RA TKA, with improved efficiency and surgeon confidence by the fifteenth procedure. These findings highlight the potential for streamlined workflows and guide training for new adopters of robotic knee arthroplasty.