University College London Hospitals and Princess Grace Hospital, London, UK.
University College London Hospitals, London, UK.
Bone Joint J. 2018 Jul;100-B(7):930-937. doi: 10.1302/0301-620X.100B7.BJJ-2017-1449.R1.
The objective of this study was to compare early postoperative functional outcomes and time to hospital discharge between conventional jig-based total knee arthroplasty (TKA) and robotic-arm assisted TKA.
This prospective cohort study included 40 consecutive patients undergoing conventional jig-based TKA followed by 40 consecutive patients receiving robotic-arm assisted TKA. All surgical procedures were performed by a single surgeon using the medial parapatellar approach with identical implant designs and standardized postoperative inpatient rehabilitation. Inpatient functional outcomes and time to hospital discharge were collected in all study patients.
There were no systematic differences in baseline characteristics between the conventional jig-based TKA and robotic-arm assisted TKA treatment groups with respect to age (p = 0.32), gender (p = 0.50), body mass index (p = 0.17), American Society of Anesthesiologists score (p = 0.88), and preoperative haemoglobin level (p = 0.82). Robotic-arm assisted TKA was associated with reduced postoperative pain (p < 0.001), decreased analgesia requirements (p < 0.001), decreased reduction in postoperative haemoglobin levels (p < 0.001), shorter time to straight leg raise (p < 0.001), decreased number of physiotherapy sessions (p < 0.001) and improved maximum knee flexion at discharge (p < 0.001) compared with conventional jig-based TKA. Median time to hospital discharge in robotic-arm assisted TKA was 77 hours (interquartile range (IQR) 74 to 81) compared with 105 hours (IQR 98 to 126) in conventional jig-based TKA (p < 0.001).
Robotic-arm assisted TKA was associated with decreased pain, improved early functional recovery and reduced time to hospital discharge compared with conventional jig-based TKA. Cite this article: Bone Joint J 2018;100-B:930-7.
本研究旨在比较传统截骨导板全膝关节置换术(TKA)与机器人辅助 TKA 的术后早期功能结果和住院时间。
本前瞻性队列研究纳入 40 例连续接受传统截骨导板 TKA 的患者,以及 40 例连续接受机器人辅助 TKA 的患者。所有手术均由同一位外科医生采用内侧髌旁入路完成,采用相同的植入物设计和标准化的术后住院康复。所有研究患者均收集住院期间的功能结果和住院时间。
在年龄(p = 0.32)、性别(p = 0.50)、体重指数(p = 0.17)、美国麻醉医师协会评分(p = 0.88)和术前血红蛋白水平(p = 0.82)方面,传统截骨导板 TKA 和机器人辅助 TKA 两组患者之间无系统差异。与传统截骨导板 TKA 相比,机器人辅助 TKA 术后疼痛减轻(p < 0.001)、镇痛需求减少(p < 0.001)、术后血红蛋白水平下降减少(p < 0.001)、直腿抬高时间缩短(p < 0.001)、理疗次数减少(p < 0.001)和出院时最大膝关节屈曲度改善(p < 0.001)。机器人辅助 TKA 的中位住院时间为 77 小时(四分位距(IQR)74 至 81),而传统截骨导板 TKA 为 105 小时(IQR 98 至 126)(p < 0.001)。
与传统截骨导板 TKA 相比,机器人辅助 TKA 可减轻疼痛,改善早期功能恢复,并减少住院时间。