Jinnah Alexander H, Augart Marco A, Lara Daniel L, Jinnah Riyaz H, Poehling Gary G, Gwam Chukwuweike U, Plate Johannes F
Department of Orthopaedic Surgery, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina.
Department of Orthopaedic Surgery, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, Department of Orthopaedic Surgery, Southeastern Regional Medical Center, Lumberton, North Carolina.
Surg Technol Int. 2018 Jun 1;32:279-283.
Unicompartmental knee arthroplasty (UKA) is a commonly used procedure for patients suffering from debilitating unicompartmental knee arthritis. For UKA recipients, robotic-assisted surgery has served as an aid in improving surgical accuracy and precision. While studies exist detailing outcomes of robotic UKA, to our knowledge, there are no studies assessing time to return to work using robotic-assisted UKA. Thus, the purpose of this study was to prospectively assess the time to return to work and to achieve the level of work activity following robotic-assisted UKA to create recommendations for patients preoperatively. We hypothesized that the return to work time would be shorter for robotic-assisted UKAs compared with TKAs and manual UKAs, due to more accurate ligament balancing and precise implementation of the operative plan.
Thirty consecutive patients scheduled to undergo a robotic-assisted UKA at an academic teaching hospital were prospectively enrolled in the study. Inclusion criteria included employment at the time of surgery, with the intent on returning to the same occupation following surgery and having end-stage knee degenerative joint disease (DJD) limited to the medial compartment. Patients were contacted via email, letter, or phone at two, four, six, and 12 weeks following surgery until they returned to work. The Baecke physical activity questionnaire (BQ) was administered to assess patients' level of activity at work pre- and postoperatively. Statistical analysis was performed using SAS Enterprise Guide (SAS Institute Inc., Cary, North Carolina) and Excel® (Microsoft Corporation, Redmond, Washington). Descriptive statistics were calculated to assess the demographics of the patient population. Boxplots were generated using an Excel® spreadsheet to visualize the BQ scores and a two-tailed t-test was used to assess for differences between pre- and postoperative scores with alpha 0.05.
The mean time to return to work was 6.4 weeks (SD=3.4, range 2-12 weeks), with a median time of six weeks. There was no difference seen in the mean pre- and postoperative BQ scores (2.70 vs. 2.69, respectively; p=0.87).
The findings of the current study suggest that most patients can return to work six weeks following robotic-assisted UKA which appears to be shorter than conventional UKA and TKA. Future level I studies are needed to verify our study findings.
单髁膝关节置换术(UKA)是治疗严重单髁膝关节关节炎患者常用的手术方法。对于接受UKA手术的患者,机器人辅助手术有助于提高手术的准确性和精确性。虽然有研究详细介绍了机器人辅助UKA的手术效果,但据我们所知,尚无研究评估采用机器人辅助UKA术后恢复工作的时间。因此,本研究的目的是前瞻性评估机器人辅助UKA术后恢复工作的时间以及达到术前工作活动水平的情况,以便为患者术前提供建议。我们假设,由于机器人辅助UKA能更精确地平衡韧带并精准实施手术计划,与全膝关节置换术(TKA)和传统UKA相比,其术后恢复工作的时间会更短。
连续纳入30例计划在一所学术教学医院接受机器人辅助UKA手术的患者。纳入标准包括手术时已就业,术后打算回到原工作岗位,且患有终末期膝关节退行性关节病(DJD),病变局限于内侧间室。术后2周、4周、6周和12周通过电子邮件、信件或电话联系患者,直至其恢复工作。采用贝克体力活动问卷(BQ)评估患者术前和术后的工作活动水平。使用SAS企业指南(SAS Institute Inc.,北卡罗来纳州卡里)和Excel®(微软公司,华盛顿州雷德蒙德)进行统计分析。计算描述性统计量以评估患者群体的人口统计学特征。使用Excel®电子表格生成箱线图以直观显示BQ评分,并采用双尾t检验评估术前和术后评分的差异,α值设定为0.05。
恢复工作的平均时间为6.4周(标准差=3.4,范围2 - 12周),中位时间为6周。术前和术后BQ评分的平均值无差异(分别为2.70和2.69;p = 0.87)。
本研究结果表明,大多数患者在接受机器人辅助UKA术后6周即可恢复工作,这似乎比传统UKA和TKA术后恢复工作的时间更短。未来需要开展I级研究以验证我们的研究结果。