Analysis of robot specific operative time and surgical team anxiety level and its effect on alignment during robot assisted TKA

Background: Adapting to robotic assisted (RA) total knee arthroplasty (TKA) is hindered by the surgeon's fear of extra time. The main purpose of this study was to determine the robot's operative time, and the secondary goals were to assess the surgical team's anxiety, implant location and size, and limb alignment. Methods: From February to April 2022, 40 participants participated in a prospective research. The study included primary Cuvis joint active RA-TKA patients for end-stage arthritis, but conventional TKA patients, conversion of unicompartmental knee arthroplasty to TKA, and patients with prior knee surgery were excluded. The active RA-TKA surgical time included surgeon-dependent and surgeon-independent/active robot time. The surgeon's anxiety was measured using the state-trait anxiety inventory (STAI). The implant size/position and limb alignment were checked by post-operative weight-bearing lateral, anteroposterior, and full-length scanograms. Results: Operative time specifically related to active RA-TKA was higher in the first 10 cases as against 10–20, 20–30 and 30–40 cases which was observed to lower from cohort 2. Similar trend was observed for the surgical team’s anxiety levels which seem to lower from cohort 2 (case 10–20). Cumulative experience of active RA-TKA showed no effect on the precision of implant alignment/ size, limb alignment and complications. Conclusion: The study showed progressive improvement in the surgical anxiety scores and reduction in operating time indicating the proficiency gained by the surgical team. Further no learning curve was involved for achieving the implant positioning and sizing, limb alignment with absence of complications.