Center for Joint Disease, Chonnam National University Hwasun Hospital, 160, Ilsim-Ri, Hwasun-Eup, Hwasun-Gun, Jeonnam, 519-809, South Korea.
Department of Orthopaedic Surgery, Chonnam National University Hwasun Hospital, 160 Ilsimri, Hwasun-Gun, Jeonnam, 519-809, South Korea.
Int Orthop. 2019 Jun;43(6):1345-1354. doi: 10.1007/s00264-018-4231-1. Epub 2018 Nov 19.
The aim of this study was (1) to compare the clinical and radiological outcomes of robotic and conventional total knee arthroplasty with a minimum follow-up of ten years, (2) to evaluate the survival rate, (3) and to estimate the accuracy of the two techniques by analyzing the outliers of the total knee arthroplasty (TKA) patients.
We evaluated 351 patients (390 knees), 155 patients undergoing robotic TKA, and 196 patients treated with conventional TKA with a mean follow-up of 11.0 years. HSS, KSS, WOMAC, and SF-12 questionnaires were used for clinical evaluation. Mechanical alignment, implant radiological measurements, and outliers were analyzed for radiological results. Kaplan-Meier survival analysis was performed for survival rate.
All clinical assessments showed excellent improvements in both groups (all p < 0.05), without any significant difference between the groups (p > 0.05). The conventional TKA group showed a significantly higher number of outliers compared with the robotic TKA group (0 < 0.05). The cumulative survival rate was 98.8% in the robotic TKA group and 98.5% in the conventional TKA group with excellent survival (p = 0.563).
Our study showed excellent survival with both robotic and conventional TKA and similar clinical outcomes at long-term follow-up. And, in terms of radiological outcome, robotic TKA showed better accuracy and consistency with fewer outliers compared with conventional TKA. With longer follow-up and larger cohort, the accuracy and effectiveness of robotic TKA on implant survival rate can be elucidated in the future.
本研究旨在（1）比较机器人辅助与传统全膝关节置换术的临床和影像学结果，随访时间至少为十年；（2）评估生存率；（3）通过分析全膝关节置换术（TKA）患者的离群值来评估两种技术的准确性。
我们评估了 351 例患者（390 膝），其中 155 例接受机器人 TKA，196 例接受传统 TKA，平均随访 11.0 年。采用 HSS、KSS、WOMAC 和 SF-12 问卷进行临床评估。对影像学结果进行机械对线、植入物放射学测量和离群值分析。采用 Kaplan-Meier 生存分析评估生存率。
两组患者的所有临床评估均显示出显著改善（均 p<0.05），但两组之间无显著差异（p>0.05）。传统 TKA 组的离群值明显多于机器人 TKA 组（p<0.05）。机器人 TKA 组的累积生存率为 98.8%，传统 TKA 组为 98.5%，均为优秀生存率（p=0.563）。
我们的研究表明，机器人辅助和传统 TKA 均具有出色的生存率，且长期随访的临床结果相似。在影像学结果方面，机器人 TKA 与传统 TKA 相比，准确性更高，一致性更好，离群值更少。随着更长时间的随访和更大的队列，未来可以阐明机器人 TKA 对植入物生存率的准确性和有效性。
