Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital (RPAH), PO Box M157, Sydney, NSW, 2050, Australia.
Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
Int Orthop. 2019 Jun;43(6):1283-1295. doi: 10.1007/s00264-018-4140-3. Epub 2018 Sep 15.
The purpose of the study is to determine the effectiveness of semi-active and active robotic hip and knee arthroplasty on post-operative patient-reported outcomes of function, pain, quality of life and satisfaction with surgery.
PubMed, Medline, Embase and CENTRAL were searched. Included were comparative studies investigating the effectiveness of semi-active or active robotic hip or knee arthroplasty compared to any other surgical intervention on function, pain, quality of life and satisfaction with surgery. Risk of bias and the strength of the evidence were assessed using the Downs and Black tool and the GRADE system, respectively. Relative risks, mean differences and 95% CI were calculated using random-effects models.
Fourteen studies involving 1342 patients were included. All studies compared robotic to conventional surgery, with active robotic surgery evaluated in total hip or knee arthroplasty and semi-active robotic surgery in total hip or unicompartmental knee arthroplasty. Most studies presented some risk of bias, and the strength of evidence was rated as low to very low quality. Random-effects meta-analyses showed that post-operative functional outcomes were comparable between active robotic and conventional total hip and knee arthroplasty at the short-, medium- and long-term follow-up. No significant difference in pain, quality of life and satisfaction with surgery were reported in individual studies.
This systematic and meta-analyses indicates that functional outcomes for patients undergoing active robotic total hip and knee arthroplasty were comparable to conventional surgery. Whether semi-active or active robotic hip or knee arthroplasty is effective in improving post-operative pain, quality of life and satisfaction with surgery is unclear. PROSPERO Registration Number: CRD42017059932.
本研究旨在确定半主动和主动机器人髋关节和膝关节置换术对术后患者报告的功能、疼痛、生活质量和手术满意度的效果。
检索了 PubMed、Medline、Embase 和 CENTRAL。纳入了比较半主动或主动机器人髋关节或膝关节置换术与任何其他手术干预在功能、疼痛、生活质量和手术满意度方面效果的研究。使用 Downs 和 Black 工具和 GRADE 系统评估风险偏倚和证据强度。使用随机效应模型计算相对风险、均数差和 95%置信区间。
共纳入 14 项涉及 1342 例患者的研究。所有研究均将机器人与常规手术进行比较，其中主动机器人手术评估了全髋关节或膝关节置换术，半主动机器人手术评估了全髋关节或单髁膝关节置换术。大多数研究存在一定的风险偏倚，证据强度被评为低至极低质量。随机效应荟萃分析显示，主动机器人和常规全髋关节和膝关节置换术在短期、中期和长期随访时的术后功能结果相当。个别研究未报告疼痛、生活质量和手术满意度的显著差异。
这项系统评价和荟萃分析表明，接受主动机器人全髋关节和膝关节置换术的患者的功能结果与常规手术相当。半主动或主动机器人髋关节或膝关节置换术在改善术后疼痛、生活质量和手术满意度方面是否有效尚不清楚。PROSPERO 注册号：CRD42017059932。
