Marcovigi Andrea, Zambianchi Francesco, Sandoni Dario, Rivi Elisa, Catani Fabio
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Acta Biomed. 2017 Jun 7;88(2S):54-59. doi: 10.23750/abm.v88i2-S.6514.
UKA has proven to be an effective surgical procedure, but its survivorship is still negatively affected by inaccuracy in component component positioning, implant and limb alignment. Robotic surgery has been introduced in order to minimize such technical errors. The aim of the present paper was to evaluate clinical and surgical outcomes after a 3 years' experience of robotic assisted UKA with the Mako Robotic Arm.
Seventy-three patients undergoing UKA with robotic instrumentation (65 medial UKAs, 8 lateral UKAs) and with a clinical follow-up of 3 -37 months were included in the present study. A complete clinical evaluation with KOOS, FJS-12 and SF-12 was administered to all patients pre and post operatively. Post-operative HKA angle and surgical time were also recorded.
Mean post-operative KOOS score was 81.32 (SD 17.19), while the mean FJS-12 score was 75.51 (SD 30.12) and the mean SF-12 Physical Score 42.25 (SD 9.97). 91% to 88% of post-operative results were considered satisfactory. Only 1 UKA failure was reported (1.3%) caused by peri-prosthetic infection. In medial UKAs mean postoperative HKA angle in extension was 3.9° varus (SD 2.5°), with no case of overcorrection; in lateral UKAs mean postoperative HKA angle in extension was 1.9° valgus (SD 1.9°) with 1 case (13%) of overcorrection. Mean skin to skin surgical time decreased from 83.2 minutes (SD 13.0) to 70.0 minutes (SD 10.9) along the learning curve.
Robotic UKA has provided an improvement both in clinical and technical results, determining satisfactory clinical outcomes and a low risk of post-operative complications.
单髁膝关节置换术（UKA）已被证明是一种有效的外科手术，但其假体生存率仍受到组件定位不准确、植入物和肢体对线的负面影响。引入机器人手术是为了尽量减少此类技术误差。本文的目的是评估使用Mako机器人手臂进行机器人辅助UKA三年后的临床和手术结果。
本研究纳入了73例行机器人辅助UKA手术的患者（65例内侧UKA，8例外侧UKA），临床随访时间为3至37个月。所有患者在术前和术后均接受了使用膝关节损伤和骨关节炎疗效评分（KOOS）、12项功能膝关节评分（FJS-12）和简明健康调查（SF-12）进行的全面临床评估。还记录了术后的股胫角（HKA）和手术时间。
术后KOOS评分的平均值为81.32（标准差17.19），FJS-12评分的平均值为75.51（标准差30.12），SF-12身体评分的平均值为42.25（标准差9.97）。91%至88%的术后结果被认为是满意的。仅报告了1例UKA失败（1.3%），原因是假体周围感染。在内侧UKA中，术后伸直位的平均HKA角为内翻3.9°（标准差2.5°），无过度矫正病例；在外侧UKA中，术后伸直位的平均HKA角为外翻1.9°（标准差1.9°），有1例（13%）过度矫正。沿着学习曲线，皮肤切口至皮肤切口的平均手术时间从83.2分钟（标准差13.0）降至70.0分钟（标准差10.9）。
机器人辅助UKA在临床和技术结果方面均有改善，取得了令人满意的临床效果，且术后并发症风险较低。
