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Benedikt J. Braun Department of Trauma, Hand and Reconstructive Surgery, Saarland University Hospital, Germany

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Bernd Grimm Luxembourg Institute of Health, Luxembourg

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Andrew M. Hanflik Los Alamitos Orthopaedics, Los Alamitos, California, USA

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Meir T. Marmor Department of Orthopaedic Surgery, University of California, San Francisco, California, USA

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Peter H. Richter Department of Trauma, Hand and Reconstructive Surgery, Saarland University Hospital, Germany

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Andrew K. Sands Weill Cornell Medical College, Foot and Ankle Surgery, Downtown Orthopedic Associates, New York Presbyterian Lower Manhattan Hospital, New York, USA

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Sureshan Sivananthan Orthopaedic Surgery, Pantai Hospital Kuala Lumpur, Malaysia

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learning curve has been consistently reported with adoption of this technology, 39 , 40 complications from the use of the robotic systems are rare. 41 To date, no long-term studies have been conducted to determine whether robot use leads to better

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Ulas Can Kolac Department of Orthopedics and Traumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey

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Alp Paksoy Charité University Hospital, Center for Musculoskeletal Surgery, Berlin, Germany

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Doruk Akgün Charité University Hospital, Center for Musculoskeletal Surgery, Berlin, Germany

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( 39 , 40 ). Various factors must be taken into account, such as learning curves, surgeon adaptation to the system, and time required for setting up additional devices in the operating room ( 41 ). Further research is required to determine whether

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Joris Duerinckx Ziekenhuis Oost-Limburg, Genk, Belgium

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Frederik Verstreken Monica Hospital, Antwerp, Belgium

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learning curve and little room for error. Appropriate training is essential before embarking on this procedure. Patient selection, precise preparation of the procedure and positioning of the components is essential to avoid complications ( 3 ). The learning

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Elisa Pala Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy

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Alberto Procura Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy

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Giulia Trovarelli Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy

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Antonio Berizzi Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy

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Pietro Ruggieri Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy

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the low power of the statistical analysis must be considered. Fluoroscopy time was similar for titanium and CFR-PEEK nails in the femur ( P  =  0.573) and the humerus ( P  = 0.780). The learning curve of our surgeons could explain this high surgical

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Augusto Covaro ICATME, Institut Universitari Quirón-Dexeus, Barcelona, Spain

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Gemma Vilà-Canet ICATME, Institut Universitari Quirón-Dexeus, Barcelona, Spain

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Ana García de Frutos ICATME, Institut Universitari Quirón-Dexeus, Barcelona, Spain

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Maite T. Ubierna ICATME, Institut Universitari Quirón-Dexeus, Barcelona, Spain

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Francesco Ciccolo ICATME, Institut Universitari Quirón-Dexeus, Barcelona, Spain

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Enric Caceres Universitat Autónoma de Barcelona, Spain

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carry an inherently difficult learning curve. 56 New techniques of posterior decompression have been developed to preserve spinal integrity and to minimise tissue damage by limiting bony decompression and avoiding removal of the mid-line structures

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Ilse Degreef Institute for Orthopedic Research and Training (IORT), Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium

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Kira Vande Voorde Institute for Orthopedic Research and Training (IORT), Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium

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Maarten Van Nuffel Institute for Orthopedic Research and Training (IORT), Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium

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department did confirm this increase, mostly at the beginning of a learning curve. Next to intense training and routine of the surgeon and assisting staff, future technical developments of the operating microscope are likely to improve that issue ( 37 ). In

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Maciej Otworowski Idea Ortopedia, Warsaw, Poland

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Dariusz Grzelecki Department of Orthopedics and Rheumoorthopedics, Centre of Postgraduate Medical Education, Otwock, Poland

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Krzysztof Starszak Department of Human Anatomy, Medical University of Silesia, Katowice, Poland

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Andrzej Boszczyk Trauma and Orthopedics Department, Centre of Posgraduate Medical Education, Otwock, Poland

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Mateusz Piorunek Medical University of Warsaw, Warsaw, Poland

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Bartłomiej Kordasiewicz Idea Ortopedia, Warsaw, Poland
Trauma and Orthopedics Department, Centre of Posgraduate Medical Education, Otwock, Poland

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. Choi S Bae JH Kwon YS & Kang H . Clinical outcomes and complications of cementless reverse total shoulder arthroplasty during the early learning curve period . Journal of Orthopaedic Surgery and Research 2019 14 53 . ( https://doi.org/10

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Wen-xi Sun State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China

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Wei-qiang Huang State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China

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Hua-yang Li State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China

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Hong-shen Wang State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China

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Sheng-li Guo State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China

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Jie Dong Huizhou Hospital of Guangzhou University of Chinese Medicine, Huizhou, China

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Bo-lai Chen State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China

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Yong-peng Lin State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China

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interbody fusion was cost-effective in 63% of simulations when patients were willing to pay $50 000/quality-adjusted life year (QALY) ( 56 ). (iv) In addition, the learning curves in RSS should not go unnoticed. RSS takes approximately 25 practice operations

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Thomas J. Holme Epsom & St Helier University Hospitals NHS Trust, Trauma & Orthopaedics, Carshalton, UK

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Marta Karbowiak Royal Surrey NHS Foundation Trust, Trauma & Orthopaedics, Guildford, UK

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Jennifer Clements Epsom & St Helier University Hospitals NHS Trust, Trauma & Orthopaedics, Carshalton, UK

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Ritesh Sharma Epsom & St Helier University Hospitals NHS Trust, Trauma & Orthopaedics, Carshalton, UK

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Johnathan Craik Epsom & St Helier University Hospitals NHS Trust, Trauma & Orthopaedics, Carshalton, UK

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Najab Ellahee Epsom & St Helier University Hospitals NHS Trust, Trauma & Orthopaedics, Carshalton, UK

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–280) 41 10 years 92%. 15 years 85% (without learning curve cases)* ARPE Gómez-Garrido (2019) 6 DC 137 (137) – 61.6 60.5 (55–66) 41 60.5 months 92.7% ARPE Martin-Ferrero (2020) 7 DC 188 (216) 5% 59 126 (120

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Stig Storgaard Jakobsen Department of Orthopaedic Surgery, Aarhus University Hospital, Denmark

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Søren Overgaard Orthopaedic Research Unit, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Denmark

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Kjeld Søballe Department of Orthopaedic Surgery, Aarhus University Hospital, Denmark

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Ole Ovesen Orthopaedic Research Unit, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Denmark

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Bjarne Mygind-Klavsen Department of Orthopaedic Surgery, Aarhus University Hospital, Denmark

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Christian Andreas Dippmann Section for Sports Traumatology M51, Department of Orthopaedic Surgery, Bispebjerg Hospital, Denmark

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Michael Ulrich Jensen Department of Orthopaedics, Aalborg University Hospital, Denmark

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Jens Stürup Department of Orthopaedics, National University Hospital, Denmark

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Jens Retpen Department of Orthopaedic Surgery, Copenhagen University Hospital, Gentofte, Denmark

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dysaesthesia, delayed union and heterotopic ossification). Moderate and severe neurovascular complications are most frequently reported to occur in approximately 0% to 5%. 8 , 25 - 33 The learning curve related to the occurrence of complications affects

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