Naziri Qais, Mixa Patrick J, Murray Daniel P, Abraham Roby, Zikria Bashir A, Sastry Akhilesh, Patel Preetesh D
Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center, Brooklyn, New York.
Department of Orthopaedic Surgery, University of Maryland Medical Center, Baltimore, Maryland.
Surg Technol Int. 2018 Jun 1;32:271-278.
Unicompartmental knee arthroplasty (UKA) effectively improves pain and function associated with isolated compartmental knee arthritis. The developments of computer-navigated and robotic-assisted UKA are among the most significant changes that have improved patient outcomes. This study aimed to systematically review the literature to identify differences between computer-navigated and robotic-assisted UKAs.
Twenty total articles were identified. Data pertaining to demographics, outcomes, and complications/failures were extracted from each study. Reoperation/revision rates, indications for reoperation/revision, type of procedure, and number of patients who underwent conversion to TKA (when available) were recorded.
Nine studies reported 451 computer-navigated medial UKAs, with 19 (3.9%) reportedly requiring reoperation: primary revision (n=8; 42.1%), conversion to TKA (n=6), and manipulation under anesthesia (n=5). Eleven studies reported 2,311 robotic-assisted UKAs (74 lateral UKAs), with 106 (5.0%) requiring reoperation: conversion to TKA (n=46; 43.4%), primary revision (n=43), reoperations without component-removal (n=15), subchondroplasty, and partial meniscectomy/synovectomy (both n=1). Reoperation rate discrepancy between computer-navigated and robotic-assisted UKA was not statistically significant (p=0.495); age and BMI differed between both groups (p<0.0001).
This study represents the first known comparison of revision rates of computer-navigated and robotic-assisted UKA, suggesting that these methods can benefit orthopaedic surgeons, especially those new to UKA or in a low-volume practice.
单髁膝关节置换术（UKA）能有效改善与单纯膝关节单间室关节炎相关的疼痛和功能。计算机导航和机器人辅助UKA的发展是改善患者预后的最重大变化之一。本研究旨在系统回顾文献，以确定计算机导航UKA和机器人辅助UKA之间的差异。
共确定了20篇文章。从每项研究中提取与人口统计学、预后以及并发症/失败相关的数据。记录再手术/翻修率、再手术/翻修的指征、手术类型以及转为全膝关节置换术（TKA，如有数据）的患者数量。
9项研究报告了451例计算机导航内侧UKA，据报道其中19例（3.9%）需要再手术：初次翻修（n = 8；42.1%）、转为TKA（n = 6）以及麻醉下手法治疗（n = 5）。11项研究报告了2311例机器人辅助UKA（74例外侧UKA），其中106例（5.0%）需要再手术：转为TKA（n = 46；43.4%）、初次翻修（n = 43）、未取出假体的再手术（n = 15）、软骨下成形术以及部分半月板切除术/滑膜切除术（均为n = 1）。计算机导航UKA和机器人辅助UKA之间的再手术率差异无统计学意义（p = 0.495）；两组之间的年龄和体重指数不同（p < 0.0001）。
本研究是已知的首次对计算机导航UKA和机器人辅助UKA翻修率的比较，表明这些方法对骨科医生有益，尤其是对UKA新手或手术量少的医生。
