How long does image based robotic total knee arthroplasty take during the learning phase? Analysis of the key steps from the first fifty cases

INTRODUCTION: Robotically assisted total knee arthroplasty (RA-TKA) is an emerging surgical tool. The purpose of this study was to analyze the length of time taken to perform the key steps of a RA-TKA for a surgeon and centre new to the MAKO robotic system. METHOD: This was a prospective cohort study of the first 50 patients undergoing TKA using a robotic platform (Mako, Stryker, Kalamazoo, MI, USA) performed by a single surgeon. Each key surgical step was recorded. The first 50 patients were chronologically allocated into five groups of ten and compared.RESULTS: Mean operation length was 59.4?±?7.4min with significant improvement after 30 cases. A significant effect on certain steps of the surgery also occurred over 50 cases: after 30 cases for pre-operative planning (3.8min in group 1 versus 1.2min in group 4, p