The impact of the primary surgeon's routine surgical experience on the clinical efficacy of robot-assisted knee arthroplasty.

The impact of a surgeon’s routine operative experience on outcomes in robot-assisted total knee arthroplasty (RATKA) remains unclear. This retrospective study investigated whether the volume of a surgeon’s primary conventional TKA experience influences the clinical efficacy of subsequent RATKA procedures. Based on the primary surgeon’s level of experience, a total of 167 patients undergoing RATKA were enrolled and allocated into two cohorts: Group A (surgeons with fewer than 100 prior cases, n = 64) and Group B (surgeons with more than 500 prior cases, n = 103). Perioperative data, radiographic outcomes, and clinical functional scores were compared. The results showed that while surgeons in Group B had significantly shorter intraoperative registration, osteotomy, and total operative times (P < 0.001), Incision length, blood loss, and postoperative complication rates did not differ significantly between Group A and Group B. Crucially, at both 3 and 180 days post-surgery, functional outcomes as measured by VAS, KSS, ROM, and WOMAC scores were comparable between the two groups (P > 0.05), as was the accuracy of postoperative lower limb alignment and component positioning (P > 0.05). Our findings suggest that although a surgeon’s extensive routine experience enhances procedural efficiency in RATKA, the robotic system’s precision and standardization effectively mitigate the impact of experience variability, enabling surgeons with differing backgrounds to achieve equivalent and excellent short-term clinical and radiographic outcomes. This supports the role of robotic assistance in promoting outcome homogeneity in knee arthroplasty.