Analysis of the clinical efficacy of robot-assisted left total knee arthroplasty performed by surgeons with varying levels of experience

Abstract

This study sought to compare the clinical outcomes of left total knee arthroplasty performed under robotic assistance by right-handed surgeons of differing experience levels, and to assess how such technology may improve operative precision and mitigate experience-related variations in results. A retrospective review was performed for 120 patients suffering from left knee osteoarthritis, all of whom received total knee arthroplasty from December 2020 to June 2025. Patients were divided into Group A (senior surgeons, > 10 years of experience) and Group B (junior surgeons, < 2 years of experience), each comprising 60 patients. Each group was further subdivided into robot-assisted total knee arthroplasty (RTKA) and conventional total knee arthroplasty (CTKA) subgroups, with 30 patients in each. Recorded parameters included operative time, incision length, intraoperative blood loss, postoperative hip-knee-ankle (HKA) angle, sagittal and coronal tibial and femoral component angles (LTC, FTC, LFC, FFC), as well as Knee Society Score (KSS), visual analogue scale (VAS) for pain, range of motion (ROM), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores on postoperative days 3 and 90. Complication rates were also compared. The results showed that while senior surgeons had shorter operative times and better early radiographic outcomes in conventional TKA, robotic assistance significantly improved component alignment and early clinical scores for junior surgeons, resulting in no statistically significant inter-group differences. in both radiographic and clinical outcomes. Notably, in the RTKA subgroups, there were no statistically significant disparities noted in operative outcomes when comparing procedures performed by senior and junior surgeons in any intraoperative, radiographic, or clinical parameters. Additionally, junior surgeons performing conventional left TKA had a higher incidence of femoral anterior cortical notching (NOTCH). In conclusion, robot-assisted left total knee arthroplasty enhances procedural consistency and reduces the performance gap between surgeons of different experience levels, particularly aiding junior right-handed surgeons in overcoming technical challenges associated with non-dominant side surgery, thereby showing potential to promote greater consistency in surgical outcomes and patient safety.