Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Department of Liver Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China.
Postgrad Med J. 2018 Jun;94(1112):335-341. doi: 10.1136/postgradmedj-2017-135352. Epub 2018 May 18.
Robotic-assisted total hip arthroplasty (THA) allows for accurate preoperative planning and component positioning, potentially enhancing implant survival and long-term outcomes. The relative efficacy and safety of robotic-assisted and conventional THA, however, are unclear. This systematic review and meta-analysis compared the safety and efficacy of robotic-assisted and conventional THA.
Medline, Embase and the Cochrane Library were comprehensively searched in September 2017 to identify studies comparing the safety and efficacy of robotic-assisted and conventional THA. Seven studies were included. Data of interest were extracted and analysed using Review Manager 5.3.
The seven included studies involved 1516 patients, with 522 undergoing robotic-assisted and 994 undergoing conventional THA. Compared with conventional THA, robotic-assisted THA was associated with longer surgical time (not significant); lower intraoperative complication rates (OR: 0.12, 95% CI: 0.05 to 0.34, p<0.0001 I); better cup placement, stem placement and global offset and a higher rate of heterotopic ossifications. Functional scores, limb length discrepancy and rates of revision and stress shielding were similar in the two groups. The relative amount of blood loss was unclear.
The results of this meta-analysis suggest that robotic-assisted THA has certain advantages over conventional THA, including the results of component positioning and rates of intraoperative complications. Additional comparative studies are required to determine the long-term clinical outcomes of robotic-assisted THA.
机器人辅助全髋关节置换术（THA）允许进行准确的术前规划和组件定位，从而有可能提高植入物的存活率和长期效果。然而，机器人辅助和常规 THA 的相对疗效和安全性尚不清楚。本系统评价和荟萃分析比较了机器人辅助和常规 THA 的安全性和疗效。
2017 年 9 月，全面检索了 Medline、Embase 和 Cochrane 图书馆，以确定比较机器人辅助和常规 THA 安全性和疗效的研究。纳入了 7 项研究。使用 Review Manager 5.3 提取和分析感兴趣的数据。
纳入的 7 项研究共涉及 1516 名患者，其中 522 名接受机器人辅助 THA，994 名接受常规 THA。与常规 THA 相比，机器人辅助 THA 手术时间较长（无统计学意义）；术中并发症发生率较低（OR：0.12，95%CI：0.05 至 0.34，p<0.0001 I）；髋臼杯和股骨柄的位置以及整体偏移更好，异位骨化发生率更高。两组的功能评分、肢体长度差异、翻修率和应力遮挡率相似。两组的相对出血量尚不清楚。
本荟萃分析的结果表明，机器人辅助 THA 相对于常规 THA 具有一定的优势，包括组件定位和术中并发症发生率的结果。需要进一步的比较研究来确定机器人辅助 THA 的长期临床效果。
