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机器人辅助单髁膝关节置换术与传统单髁膝关节置换术相比并无早期优势。

Robotic-assisted unicompartmental knee replacement offers no early advantage over conventional unicompartmental knee replacement.

机构信息

Maimonides Medical Center Brooklyn, New York, USA.

Department of Orthopaedic Surgery, Center for Hip and Knee Replacement (CHKR), NewYork-Presbyterian Hospital at Columbia University Medical Center, 622 W. 168th Street, PH 1155, New York, NY, 10032, USA.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2019 Jul;27(7):2303-2308. doi: 10.1007/s00167-019-05386-6. Epub 2019 Feb 12.

Abstract

PURPOSE

Unicompartmental knee arthroplasty (UKA) is effective for treating degenerative joint disease in a single compartment. Robotic-arm-assisted arthroplasty (RAA) has gained popularity and has theoretical benefits of improved outcomes over conventional (CONV) UKA due to the technical precision of bone preparation. This study compares the short-term clinical outcomes, including survivorship and patient-reported functional outcomes, for a series of medial UKAs performed with RAA and CONV.

METHODS

One hundred seventy-six consecutive fixed-bearing medial UKAs were retrospectively identified with a minimum follow-up of 2 years. One hundred and eighteen CONV and 58 RAA were performed. Pre- and post-operative SF12, WOMAC, and KSS Functional Questionnaires were available for all patients.

RESULTS

At 2 years, both groups improved in all functional outcomes, with no significant difference between the RAA and CONV cohorts. However, the RAA cohort had a significantly longer operative time (p < 0.001) and a higher early revision rate than the CONV group (7 [12.0%] vs. 7 [6.8%]; p < 0.05).

CONCLUSIONS

These results demonstrate that at short-term follow-up of 2 years, RAA was not superior to CONV in terms of functional scores and instead was associated with greater operative time and cost and lower survivorship. Therefore, at this time usage of RAA in UKA is not recommended compared to conventional UKA. Longer term studies are necessary to draw conclusions about the overall outcomes of RAA compared to CONV.

LEVEL OF EVIDENCE

III.

摘要

目的

单髁膝关节置换术(UKA)对于治疗单个关节的退行性关节疾病非常有效。机器人辅助关节置换术(RAA)因骨准备的技术精度而具有改善结果的理论优势,已越来越受欢迎,并且已优于传统(CONV)UKA。本研究比较了一系列使用 RAA 和 CONV 进行的内侧 UKA 的短期临床结果,包括存活率和患者报告的功能结果。

方法

回顾性确定了 176 例连续的固定轴承内侧 UKA,最低随访时间为 2 年。进行了 118 例 CONV 和 58 例 RAA。所有患者均具有术前和术后 SF12、WOMAC 和 KSS 功能问卷。

结果

在 2 年时,两组在所有功能结果上均有所改善,但 RAA 和 CONV 队列之间没有显着差异。但是,RAA 队列的手术时间明显长于 CONV 组(p <0.001),并且早期翻修率也高于 CONV 组(7 [12.0%]比 7 [6.8%];p <0.05)。

结论

这些结果表明,在 2 年的短期随访中,RAA 在功能评分方面并不优于 CONV,反而与更长的手术时间、更高的成本和更低的存活率相关。因此,目前与 CONV 相比,不建议在 UKA 中使用 RAA。需要进行更长时间的研究,才能得出关于 RAA 与 CONV 总体结果的结论。

证据水平

III。

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