Efficacy study of robot-assisted total knee arthroplasty in patients with different levels of medical experience

This study aims to explore whether RA-TKA can effectively bridge the gap in surgical accuracy and efficacy caused by differences in the original experience of surgeons through its “low precision learning curve” characteristic. A retrospective analysis was conducted on 100 patients with knee osteoarthritis who underwent total knee arthroplasty from January 2023 to December 2024. The patients were divided into four groups based on the surgeon and the type of surgery: low-experience doctors performed CTKA, low-experience doctors performed RA-TKA, high-experience doctors performed CTKA, and high-experience doctors performed RA-TKA. The main evaluation indicators included operation time, incision length, intraoperative blood loss, imaging accuracy (HKA angle, FFC, FTC, LTC), and early clinical outcomes (KSS score, joint range of motion ROM, pain VAS score). In terms of surgical efficiency, the total operation time and incision length of the low-experience doctor group (Group A) were longer than those of the high-experience doctor group (Group B) (P < 0.05). Within the groups, regardless of the doctor’s experience, the operation time and incision length of the RA-TKA group were longer than those of the same group’s CTKA group, but the intraoperative blood loss was reduced (P < 0.05). However, within the RA-TKA group, there were no significant differences in operation time, incision length, and blood loss between the high-experience and low-experience doctors (P > 0.05); while in the CTKA group, the operation time and incision length of the low-experience doctors were significantly higher than those of the high-experience doctors (P < 0.05). In terms of surgical accuracy, the imaging indicators (HKA, FFC, FTC, LTC) of the patients in Group B were overall better than those in Group A (P < 0.05). Within the groups, in the low-experience doctor group (Group A), RA-TKA was significantly better than CTKA in all measurement indicators (HKA, FFC, FTC, LTC) (P < 0.01); in the high-experience doctor group (Group B), RA-TKA was only better than CTKA in the HKA angle (P < 0.05). The key finding was that in the CTKA group, high-experience doctors were significantly better than low-experience doctors in all imaging indicators (P < 0.05), but in the RA-TKA group, there were no statistical differences in all precision indicators between the high-experience and low-experience doctors (P > 0.05). In terms of clinical function, at 3 days after surgery, the KSS and ROM of the A-RA-TKA group were significantly better than those of the A-CTKA group, and the VAS pain score was lower (P < 0.05). At 1 year after surgery, this advantage still existed in KSS and ROM (P < 0.05). For high-experience doctors, robot-assisted surgery improved KSS at 3 days after surgery and ROM at 1 year. For low-experience doctors (A-RA-TKA), the clinical function results at the same time points were mostly not significantly different from those of high-experience doctors (B-RA-TKA) (P > 0.05, except for a slight but significant statistical difference in VAS at 1 year). RA-TKA can effectively improve the surgical accuracy of low-experience doctors, enabling them to reach the same level as high-experience doctors in the early application stage.