Learning curve of total ankle replacement from the lateral approach

Figure 3 Learning curve for total ankle replacement. Duration of total ankle replacement procedures (minutes) plotted against consecutive case number. Operative time progressively decreased from approximately 175 min in the first ten cases to around 120 min after 30 procedures, indicating a clear learning effect and progressive improvement in surgical efficiency. Mean operative time significantly decreased after the first 26 cases (154.7 ± 29.7 min vs 122.9 ± 17.9 min; P < 0.0001), demonstrating stabilization of procedural performance beyond the initial learning phase and reaching approximately 110 min in the most recent cases.