Department of Orthopaedic Surgery and Computer Assisted Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY.
Department of Orthopaedic Surgery, Rebound Orthopedics & Neurosurgery, Portland, OR.
J Arthroplasty. 2018 Jun;33(6):1719-1726. doi: 10.1016/j.arth.2018.01.036. Epub 2018 Jan 31.
Studies have showed improved accuracy of lower leg alignment, precise component position, and soft-tissue balance with robotic-assisted unicompartmental knee arthroplasty (UKA). No studies, however, have assessed the effect on midterm survivorship. Therefore, the purpose of this prospective, multicenter study was to determine midtem survivorship, modes of failure, and satisfaction of robotic-assisted medial UKA.
A total of 473 consecutive patients (528 knees) underwent robotic-arm-assisted medial UKA surgery at 4 separate institutions between March 2009 and December 2011. All patients received a fixed-bearing, metal-backed onlay tibial component. Each patient was contacted at minimum 5-year follow-up and asked a series of questions to determine survival and satisfaction. Kaplan-Meier method was used to determine survivorship.
Data were collected for 384 patients (432 knees) with a mean follow-up of 5.7 years (5.0-7.7). The follow-up rate was 81.2%. In total, 13 revisions were performed, of which 11 knees were converted to total knee arthroplasty and in 2 cases 1 UKA component was revised, resulting in 97% survivorship. The mean time to revision was 2.27 years. The most common failure mode was aseptic loosening (7/13). Fourteen reoperations were reported. Of all unrevised patients, 91% was either very satisfied or satisfied with their knee function.
Robotic-arm-assisted medial UKA showed high survivorship and satisfaction at midterm follow-up in this prospective, multicenter study. However, in spite of the robotic technique, early fixation failure remains the primary cause for revision with cemented implants. Comparative studies are necessary to confirm these findings and compare to conventional implanted UKA and total knee arthroplasty.
研究表明，机器人辅助单髁膝关节置换术（UKA）可提高小腿对线、精确组件位置和软组织平衡的准确性。然而，目前还没有研究评估其对中期生存率的影响。因此，本前瞻性、多中心研究旨在确定机器人辅助内侧 UKA 的中期生存率、失败模式和患者满意度。
2009 年 3 月至 2011 年 12 月，4 家机构共对 473 例（528 膝）连续患者进行了机器人辅助内侧 UKA 手术。所有患者均接受了固定轴承、金属背衬的胫骨垫块。所有患者在至少 5 年随访时均被联系，并被问及一系列问题以确定生存率和满意度。Kaplan-Meier 法用于确定生存率。
共收集了 384 例患者（432 膝）的资料，平均随访时间为 5.7 年（5.0-7.7）。随访率为 81.2%。共进行了 13 次翻修，其中 11 例膝关节翻修为全膝关节置换术，2 例翻修了 1 个 UKA 组件，生存率为 97%。翻修的平均时间为 2.27 年。最常见的失败模式是无菌性松动（7/13）。报告了 14 例再手术。所有未翻修患者中，91%对膝关节功能非常满意或满意。
在这项前瞻性、多中心研究中，机器人辅助内侧 UKA 在中期随访中显示出高生存率和满意度。然而，尽管采用了机器人技术，对于使用水泥固定植入物的患者，早期固定失败仍然是翻修的主要原因。需要进行比较研究以确认这些发现，并与传统植入式 UKA 和全膝关节置换术进行比较。
