The learning curve for a novel, fluoroscopy‐based robotic‐assisted total hip arthroplasty system

Abstract Background Adoption of robotic‐assisted total hip arthroplasty (RA‐THA) systems can improve the accuracy of acetabular cup placement, but no group has reported the learning curve of novel, fluoroscopy‐based RA‐THA systems. Methods A learning‐curve cumulative summation (LC‐CUSUM) analysis was performed on a consecutive series of the first 100 patients who received fluoroscopy‐based RA‐THA by the study surgeon. Operative times and specific robotic timepoints were compared between learning and proficiency phases. Results Implementation of fluoroscopy‐based RA‐THA was associated with a learning curve of 12 cases. A 6‐min increase in operative time was seen during the learning phase compared to the proficiency phase (44.3 ± 4.4 vs. 38.0 ± 7.1 min; p < 0.001), with a 3‐min longer robotic cup impaction sequence during the learning phase (7.8 ± 1.9 vs. 4.8 ± 1.3 min; p < 0.001). Conclusion Adoption of fluoroscopy‐based RA‐THA is associated with a brief learning curve of 12 cases, with the most significant improvements in surgical efficiency realised during acetabular cup placement.