pirogovestnikВестник Национального медико-хирургического центра им. Н.И. ПироговаBulletin of Pirogov National Medical & Surgical Center2072-82552782-3628Национальный медико-хирургический Центр им. Н.И. Пирогова10.25881/20728255_2026_21_1_83pirogovestnik-539Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESКРИВАЯ ОБУЧЕНИЯ ОПЫТНОГО ХИРУРГА И РАННИЕ РЕЗУЛЬТАТЫ ПРИМЕНЕНИЯ РОБОТИЧЕСКОЙ СИСТЕМЫ CORI ПРИ ЭНДОПРОТЕЗИРОВАНИИ КОЛЕННОГО СУСТАВАLEARNING CURVE OF EXPERIENCED SURGEON AND EARLY RESULTS OF THE CORI ROBOTIC SYSTEM IN KNEE REPLACEMENTАйрапетовГ. А.AirapetovG. A.

Москва

Moscow

ДанильянцА. А.DaniliyantsA. A.

Москва

Moscow

armendts@mail.ruЗагороднийН. В.ZagorodniyN. V.

Москва

Moscow

СулейманянцД. К.SuleymanyantsD. K.

Москва

Moscow

ЯцуковаВ. Е.YatsukovaV. E.

Челябинск

Chelyabinsk

АхматА. А.AhmatA. A.

Москва

Moscow

Аль КафавинА.Х.А.Al KafavinA.Kh.A.

Москва

Moscow

СамковичД. А.SamkovichD. A.

Москва

Moscow

Российский университет дружбы народов; Городская клиническая больница №31 им. академика Г.М. СавельевойРоссияPeoples’ Friendship University of Russia named after Patrice Lumumba; City Clinical Hospital №31 named after Academician G.M. Savelyeva of the Moscow City Healthcare DepartmentRussian FederationРоссийский университет дружбы народов; Национальный медицинский исследовательский центр травматологии и ортопедии им. Н.Н. ПриороваРоссияPeoples’ Friendship University of Russia named after Patrice Lumumba; National Medical Research Center for Traumatology and Orthopedics named after N.N. PriorovRussian FederationРоссийский университет дружбы народовРоссияPeoples’ Friendship University of Russia named after Patrice LumumbaRussian FederationЮжно-Уральский государственный медицинский университетРоссияSouth Ural State Medical University of the Ministry of Health of the Russian FederationRussian Federation2026210320262118388Copyright © Айрапетов Г.А., Данильянц А.А., Загородний Н.В., Сулейманянц Д.К., Яцукова В.Е., Ахмат А.А., Аль Кафавин А., Самкович Д.А., 20262026Айрапетов Г.А., Данильянц А.А., Загородний Н.В., Сулейманянц Д.К., Яцукова В.Е., Ахмат А.А., Аль Кафавин А., Самкович Д.А.Airapetov G.A., Daniliyants A.A., Zagorodniy N.V., Suleymanyants D.K., Yatsukova V.E., Ahmat A.A., Al Kafavin A., Samkovich D.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://submit.pirogov-vestnik.ru/jour/article/view/539Введение

Введение. Эндопротезирование коленного сустава является методом выбора при лечении поздних стадий гонартроза. Новый этап развития технологий в ортопедии связан с внедрением в практику хирурговортопедов роботических систем.

Цель работы – оценить кривую обучения и сравнить ранние результаты эндопротезирования коленного сустава с применением роботической системы CORI с мануальным способом замены сустава.

Материалы и методы

Материалы и методы. В проспективном исследовании приняло участие 30 пациентов (11 мужчин, 19 женщин), которые с целью рандомизации были разделены на две группы с использованием генератора случайных чисел: группа №1 (n = 15), пациентам выполнялось роботизированное эндопротезирование коленного сустава с применением системы CORI компании Smith & Nephew; группа №2 (n = 15), пациентам выполнено эндопротезирование коленного сустава мануальным способом. Оценка функционального состояния коленного сустава в послеоперационном периоде проводилась и использованием опросника KSS.

Результаты

Результаты. Анализ кривой обучения хирурга, имеющего опыт применения других роботических систем, показал, что, начиная с 3-ой операции её длительность начала снижаться и вышла на плато с 6-го применения роботической системы CORI. В группе №1 длительность операции была статистически значимо больше, по сравнению с группой №2. Объём интраоперационной кровопотери был сопоставим в обеих группах. Значения показателя KSS были статистически значимо выше в группе №1.

Обсуждение

Обсуждение. Авторы предполагают, что основной причиной более высоких баллов KSS в группе №1 является минимальный мягкотканный релиз, в данном исследовании достигаемый применением подхода функционального выравнивания.

Заключение

Заключение. Полученные в ходе исследования данные свидетельствуют о том, что хирург, имеющийся опыт применения других роботических систем, может преодолеть кривую обучения и выйти на плато уже на 6-ом эндопротезировании коленного сустава. При этом длительность операции с применением роботической системы после преодоления кривой обучения была дольше, в сравнении с мануальной методикой. Применение подхода функционального выравнивания оси нижней конечности способствовало более высоким показателям KSS в раннем послеоперационном периоде, однако для более точного понимания необходимы дальнейшие исследования.

Introduction

Introduction. Knee arthroplasty is the method of choice in the treatment of late stages of gonarthrosis. A new stage in the development of technologies in orthopedics is associated with the introduction of robotic systems into the practice of orthopedic surgeons.

The aim of the study

The aim of the study: to evaluate the learning curve and compare early outcomes of knee replacement using the CORI robotic system with manual joint replacement.

Materials and methods

Materials and methods. The prospective study involved 30 patients (11 men, 19 women), who were randomized into two groups using a random number generator: Group 1 (n = 15), patients underwent robotic knee arthroplasty using the CORI system from Smith&nephew; Group 2 (n = 15), patients underwent manual knee arthroplasty. Evaluation of the functional state of the knee joint in the postoperative period was also carried out using the KSS questionnaire.

Results

Results. Analysis of the learning curve of a surgeon with experience in using other robotic systems showed that starting from the 3rd case, the duration of the operation began to decrease and reached a plateau from the 6th case of using the CORI robotic system. In group №1, the duration of the operation was statistically significantly longer compared to group №2. The volume of intraoperative blood loss was comparable in both groups. The KSS values were statistically significantly higher in group №1.

Discussion

Discussion. The authors suggest that the main reason for the higher KSS scores in group №1 is the minimal soft tissue release, which in this study was achieved using the functional alignment approach.

Conclusion

Conclusion. The data obtained during the study indicate that the existing experience in using robotic systems contributes to a faster mastery of the robot-assisted CORI system. In our opinion, a surgeon with experience in working with a robotic system can overcome the learning curve and reach a plateau already at the 6th case of knee arthroplasty. Moreover, the duration of the operation using the robotic system after overcoming the learning curve was longer, compared to the manual technique.

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The authors declare that there are no conflicts of interest present.