Open Access
Table 3
Summary of published studies on the learning curve in total knee arthroplasty. TKA = Total Knee Arthroplasty.
| Study | Procedure/Technology | Learning curve threshold | Sample size | Main outcome measure | Key findings |
|---|---|---|---|---|---|
| [2] | Various new implant technologies in TKA | ~50 cases | Review | Complication rate | Learning curve varies by technology and team experience |
| [12] | Manual instruments TKA with unrestricted kinematic alignment | ~20 cases | 60 | Operative time | Short learning curve; outcomes comparable to experienced surgeon |
| [13] | TKA using electronic sensor | ~40 cases | 164 | Operative time | Gradual reduction in time with experience |
| [14] | Change in implant design in high-volume center | 30 cases | n = 2,329 (1,061 PFC®, 1,268 Genesis™ II) | Operative time, complications | Slight increase in OR time (<5 min); stabilization after 30 cases; no difference in complications |
| [15] | Robotic-assisted TKA (HURWA) | 8–20 cases | 50 | Operative time, alignment | Improved alignment and OR time after early cases |
| [16] | Robotic-assisted TKA (NAVIO) | ~10 cases | 101 | Operative time | Quick learning curve, progressive stabilization |
| [17] | Robotic-assisted TKA | ~40 cases | 386 | Operative time, alignment | Learning curve only for time, not for alignment or gaps |
| [18] | Team familiarity in TKA | No fixed threshold; progressive gain up to 10 + collaborations | 4,276 | Operative time | Operative time decreased with prior team collaboration |
| [19] | Introduction of new TKA implants | 15–100 cases | 46,363 | Revision risk | Higher revision in first cases, stable outcomes after 100 |
| [20] | Anterior approach THA | ~50 cases | Registry data | Revision rate | Risk stabilizes after 50 cases |
| [21] | THA anterior approach (senior vs. junior) | 70 cases | 547 | Operative time, complications | Juniors had higher complication rate; time stabilized after 70 cases |
| [22] | Robotic-assisted TKA (CORI) | 6 cases | 500 | CUSUM events | CUSUM learning curve short despite early perioperative events |
| [23] | TKA in hemophilic patients | 30 cases | 90 | Complication rate | Significant decline in complications after 30 cases |
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