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Gareth G. Jones MSk Lab, Imperial College London, UK.

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Susannah Clarke MSk Lab, Imperial College London, UK.

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Martin Jaere MSk Lab, Imperial College London, UK.

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Justin Cobb MSk Lab, Imperial College London, UK.

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, but one explanation is that UKA is a technically demanding procedure with a significant learning curve. 17 Over- or under-correction of leg alignment is associated with an increased risk of failure, and the tolerances for tibial component

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Ahmed Siddiqi Cleveland Clinic Foundation, Department of Orthopedics Cleveland, Ohio, USA

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Timothy Horan Philadelphia College of Osteopathic Medicine, Department of Orthopedics, Philadelphia, Pennsylvania, USA

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Robert M. Molloy Cleveland Clinic Foundation, Department of Orthopedics Cleveland, Ohio, USA

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Michael R. Bloomfield Cleveland Clinic Foundation, Department of Orthopedics Cleveland, Ohio, USA

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Preetesh D. Patel Cleveland Clinic Florida, Department of Orthopedics, Weston, Florida, USA

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Nicolas S. Piuzzi Cleveland Clinic Foundation, Department of Orthopedics Cleveland, Ohio, USA

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investigates the advent of robotic navigation, historical and commercially available systems, learning curve, clinical outcomes, cost-analysis and limitations to better understand the value of RA-TKA. Robotic total knee arthroplasty systems History

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Claus Varnum The Danish Hip Arthroplasty Register
Department of Orthopaedic Surgery, Vejle Hospital, Vejle, Denmark

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Alma Bečić Pedersen Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark

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Per Hviid Gundtoft Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark

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Søren Overgaard The Danish Hip Arthroplasty Register
Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark
Orthopaedic Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark

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volume (hospitals operating ⩽ 50 procedures per year had an increased risk of revision after two-, five-, ten- and 15-year follow-up); 29 set-up including fast-track; 30 and surgeon’s skills including learning-curve and positioning of components

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Halah Kutaish Centre for Surgery of the Foot & Ankle, Hirslanden Clinique La Colline, Switzerland
Faculty of Medicine, Geneva University, Switzerland

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Antoine Acker Centre for Surgery of the Foot & Ankle, Hirslanden Clinique La Colline, Switzerland

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Lisca Drittenbass Centre for Surgery of the Foot & Ankle, Hirslanden Clinique La Colline, Switzerland

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Richard Stern Centre for Surgery of the Foot & Ankle, Hirslanden Clinique La Colline, Switzerland

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Mathieu Assal Centre for Surgery of the Foot & Ankle, Hirslanden Clinique La Colline, Switzerland
Faculty of Medicine, Geneva University, Switzerland

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). 7 , 8 Additionally, this technique can be useful for younger surgeons as the results of the surgery are immediately visible and therefore shorten the learning curve. Historically, CAOS was mainly used in spinal and cranial surgery, in which it

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Geert Meermans Bravis Hospital, Roosendaal, The Netherlands

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George Grammatopoulos The Ottawa Hospital, Ottawa, Ontario, Canada

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Moritz Innmann Heidelberg University Hospital, Heidelberg, Germany

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David Beverland Belfast Health and Social Care Trust, Belfast, UK

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accurate than the low-volume surgeons who performed an average of 13 THAs per year. There only have been a few studies looking at the learning curve for optimal positioning of the acetabular component in primary THA. Bosker et al. ( 14 ) found a

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Xun Wang Department of Orthopedics, Center for Plastic & Reconstructive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China

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Aiqi Zhang Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China

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Wenchao Yao Department of Orthopaedics, the First People's Hospital of Chun'an County, Hangzhou, Zhejiang, China

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Haiyan Qiu Department of Endocrinology, Afliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China

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Fabo Feng Department of Orthopedics, Center for Plastic & Reconstructive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China

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significantly higher than posterior approaches, and the learning curves are steeper. Furthermore, both anterior and lateral interbody fusion are indirect decompression, which may result in a risk of incomplete decompression for radiculopathy caused by disc

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Leonardo Tassinari I Department of Orthopedic and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, Bologna, Italy

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Alberto Di Martino I Department of Orthopedic and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, Bologna, Italy

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Matteo Brunello I Department of Orthopedic and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, Bologna, Italy

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Valentino Rossomando I Department of Orthopedic and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, Bologna, Italy

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Francesco Traina Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, Bologna, Italy
Orthopedics-Traumatology and Prosthetic Surgery and Hip and Knee Revision, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy

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Cesare Faldini I Department of Orthopedic and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, Bologna, Italy

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surgical robots and handheld navigation systems. These show very high levels of accuracy and rely on careful preoperative planning, but they require expensive equipment and a non-negligible learning curve for the technique. They are becoming increasingly

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Luciano A. Rossi Hospital Italiano de Buenos Aires, Buenos Aires City, Argentina

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Ignacio Tanoira Hospital Italiano de Buenos Aires, Buenos Aires City, Argentina

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Franco Luis De Cicco Hospital Italiano de Buenos Aires, Buenos Aires City, Argentina

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Maximiliano Ranalletta Hospital Italiano de Buenos Aires, Buenos Aires City, Argentina

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, as concluded by the authors, the congruent-arc modification is potentially less tolerant of screw-positioning error, which is a relevant finding given that the Latarjet procedure has been proven to have a long learning curve. Ekhtiari et al, 34

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Alan G. Fraser Department of Cardiology, University Hospital of Wales, Cardiff, UK

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Rob G.H.H. Nelissen Department of Orthopaedics, Leiden University Medical Center, Leiden, Netherlands

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Per Kjærsgaard-Andersen Department of Orthopaedics, Vejle Hospital, South Danish University, Vejle, Denmark

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Piotr Szymański Centre of Postgraduate Medical Education, MSWiA Central Clinical Hospital, Warsaw, Poland

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Tom Melvin Healthcare Products Regulatory Authority, Earlsfort Terrace, Dublin 2, Ireland

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Paul Piscoi Health Technology Unit B6, Directorate General for Health (DG SANTE), European Commission, Brussels, Belgium

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On behalf of the CORE–MD Investigators (see Appendix) Alan Fraser, Piotr Szymański, Chris Gale, Aldo Maggioni, Elisabetta Zanon, Christina Dimopoulou, Cinzia Ceccarelli, Polyxeni Vairami, Anett Ruszanov, Per Kjærsgaard-Andersen, Rob Nelissen, Adrian Ott, Elizabeth Macintyre, Loredana Simulescu, Marieke Meijer, Berthold Koletzko, Sarah Wieczorek, Adamos Hadjipanayis, Stefano Del Torso, Perla Marang-van de Mheen, Lotje Hoogervorst, Ewout W. Steyerberg, Bas Penning De Vries, Peter McCulloch, Martin Landray, Daniel Prieto Alhambra, James Smith, Anne Lubbeke-Wolf, Stefan James, Sergio Buccheri, Robert Byrne, Laurna McGovern, Stephan Windecker, Andre Frenk, Georgios Siontis, Christoph Stettler, Arjola Bano, Lia Bally, Frank E. Rademakers, Jan D‘hooge, Anton Vedder, Elisabetta Biasin, Erik Kamenjasevic, Petra Schnell-Inderst, Felicitas Kühne, Ola Rolfson, Joel Jakobsson, Amanda Tornsö, Enrico G. Caiani, Lorenzo Gianquintieri, Cinzia Cappiello, Maristella Matera, Tom Melvin, Niall MacAleenan, Ria Mahon, Michèle Meagher, Gearóid McGauran, Thomas Wejs Møller, Ann-Sofie Sonne Holm-Schou, Jan Szulc, Robert E. Geertsma, Jantine W.P.M. van Baal, Joëlle M. Hoebert, Susana L.F. Cabaço, Paola Laricchiuta, Marina Torre, Filippo Boniforti, Eugenio Carrani, Stefania Ceccarelli, Claudia Wild, Sabine Ettinger, Juan Antonio Blasco Amaro, Juan Carlos Rejón Parrilla, Agnieszka Dobrzynska, David Epstein, Valentina Strammiello, Hannes Jarke, Kaisa Immonen, Françoise Schlemmer, Sabina Hoekstra, Marianna Mastroroberto, Christoph Ziskoven, Michael Hahn, Erman Melikyan, Richard Holborow, Suzanne Halliday, Alexey Shiryaev, Gero Viola, Harry van Vugt

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or learning curves. Within this task, selected questions will be considered, to advise on analytical approaches that are appropriate for building up evidence. One consequence of approving new devices on the basis of limited evidence is that some

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Marko Nabergoj Valdoltra Orthopaedic Hospital, Ankaran, Slovenia
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

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Patrick J. Denard Department of Orthopaedic & Rehabilitation, Oregon Health & Science University, Portland, Oregon, USA

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Philippe Collin Centre Hospitalier Privé Saint-Grégoire (Vivalto Santé), Saint-Grégoire, France

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Rihard Trebše Valdoltra Orthopaedic Hospital, Ankaran, Slovenia
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

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Alexandre Lädermann Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Meyrin, Switzerland
Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland

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during July 2003 and March 2007. They noticed a fall in percentage of complications from 19% to 10%, mainly because of a lower rate of infection and instability. 21 The complication-related learning curve diminishes with an increase in the surgeon

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