Department of Orthopaedic Surgery, University Hospital Carl Gustav Carus, Medical Faculty of the Technical University of Dresden, Fetscherstr. 74, 01307, Dresden, Germany,
Knee Surg Sports Traumatol Arthrosc. 2013 Oct;21(10):2241-7. doi: 10.1007/s00167-013-2608-7. Epub 2013 Jul 14.
The use of computer-assisted surgery (CAS) in total knee arthroplasty (TKA) results in better limb and implant alignment compared to conventional TKA; however, it is unclear whether this translates to better mid- to long-term clinical outcome. This prospective randomised study comparing CAS and conventional TKA reports the functional and patient perceived outcomes at a follow-up of 5 years. The hypothesis was that there would be a difference in functional outcome or quality of life after mid-term follow-up.
Sixty-seven patients were available for physical and radiological examination at 5 years. The Knee Society Score (KSS) was used to describe functional outcome and the Euroquol questionnaire for quality of life.
The mean total KSS for the CAS group improved from 91.1 (SD 22.3) points preoperatively to 157.4 (SD 21.9) and 150.2 (SD 30.4) points at 2 and 5 years, respectively. In the conventional group, the mean total KSS was 99.6 (SD 18.6) points preoperatively and 151.1 (SD 26.0) and 149.0 (SD 28.0) points at 2 and 5 years, respectively. The mean quality of life score improved from 48.2 (SD 16.5) points preoperatively to 67.4 (SD 16.3) and 66.8 (SD 22.2) points at 2 and 5 years in the CAS group, and from 52.2 (SD 17.1) points preoperatively to 65.6 (SD 14.6) and 61.7 (SD 19.3) points at 2 and 5 years, respectively, in the conventional TKA group. These differences were not statistically significant. There were radiolucent lines up to 2 mm in 11 knees (four CAS, seven conventional), but there were no changes in implant position.
There were no significant differences in functional or patient perceived outcome after mid-term follow-up in this study.
I.
与传统全膝关节置换术（TKA）相比，计算机辅助手术（CAS）在全膝关节置换术中可实现更好的肢体和植入物对线，然而，目前尚不清楚这是否会转化为更好的中期至长期临床结果。这项比较 CAS 和传统 TKA 的前瞻性随机研究报告了 5 年随访时的功能和患者感知结果。假设在中期随访后，功能结果或生活质量会存在差异。
67 例患者可进行 5 年的体格检查和影像学检查。膝关节学会评分（KSS）用于描述功能结果，Euroquol 问卷用于评估生活质量。
CAS 组的平均总 KSS 从术前的 91.1（SD 22.3）分提高到术后 2 年的 157.4（SD 21.9）分和 5 年的 150.2（SD 30.4）分。在传统组中，平均总 KSS 术前为 99.6（SD 18.6）分，术后 2 年为 151.1（SD 26.0）分，5 年为 149.0（SD 28.0）分。CAS 组的平均生活质量评分从术前的 48.2（SD 16.5）分提高到术后 2 年的 67.4（SD 16.3）分和 5 年的 66.8（SD 22.2）分，而传统 TKA 组分别从术前的 52.2（SD 17.1）分提高到术后 2 年的 65.6（SD 14.6）分和 5 年的 61.7（SD 19.3）分。这些差异无统计学意义。有 11 个膝关节（4 个 CAS，7 个传统）存在 2 毫米以内的透亮线，但植入物位置没有变化。
在这项研究中，中期随访后，功能或患者感知结果没有显著差异。
I 级。
