Learning of A CAOS Enhanced Mechanical Instrument System for Total Knee Arthroplasty: A CUSUM Analysis

This study employed an advanced method (Cumulative sum control chart, CUSUM) to analyze the learning curve regarding surgical efficiency (time) in four surgeons from different experience levels upon their adoption of a mechanical instrument enhanced by computer-assisted orthopaedic surgery (CAOS). The first six CAOS-TKA cases of each surgeon were analyzed to identify the case number when their learning process was stabilized (cases to proficiency). The surgical time increase during the learning phase were compared between senior and fellow surgeons. The data demonstrated a short learning duration (2-3 cases) both senior and fellow surgeons and a mild impact from learning compared to cases performed using conventional instrument system.