Khlopas Anton, Sodhi Nipun, Hozack William J, Chen Antonia F, Mahoney Ormonde M, Kinsey Tracy, Orozco Fabio, Mont Michael A
Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
Department of Orthopaedic Surgery, Lenox Hill Hospital, Northwell Health, New York, New York.
J Knee Surg. 2020 Jul;33(7):685-690. doi: 10.1055/s-0039-1684014. Epub 2019 Apr 8.
The purpose of this study was to perform a 3-month interim comparative analysis on outcomes between robotic-arm-assisted total knee arthroplasty (RATKA) and manual TKA patients. Specifically, we evaluated (1) patient self-reported symptoms, (2) expectations and satisfaction, and (3) functional activities, based on the 2011 Knee Society Scoring System. Between June 1, 2016, and March 31, 2018, 252 patients (102 manual and 150 robotic) were enrolled into a prospective, nonrandomized, open-label, multicenter comparative cohort study. Functional activity scores, patient-reported symptoms, as well as satisfaction and expectation scores were obtained from the 2011 Knee Society Scoring System preoperatively, at 4 to 6 weeks, and at 3 months postoperatively. Student's -tests, Wilcoxon rank-sum tests, and chi-square tests with α set at 0.05 were used to compare between-group mean improvements from baseline. At 4 to 6 weeks postoperatively, RATKA patients were found to have significantly larger improvements in walking and standing (1.4 vs. -1.2 points; = 0.019). RATKA patients were also found to have larger improvements in advanced activities (1.3 vs. 2.3 points), pain with walking (3.3 vs. 3.2 points), satisfaction score (12.4 vs. 12 points), and expectations score (5.1 vs. 4.4 points) when compared with manual TKA patients. At 3 months, RATKA patients were also found to have larger improvements in walking and standing (6.0 vs. 4.8 points), standard activities (11.4 vs. 10.1 points), advanced activities (6.2 vs. 4.6 points), functional activities total score (22.8 vs. 21.2 points), pain with walking (4.3 vs. 4.1 points), total symptoms score (10.5 vs. 10.3 points), satisfaction score (17.0 vs. 15.5 points), expectations score (4.8 vs. 4.0 points) when compared with manual TKA patients. The data indicate RATKA patients to have equal or greater improvements in 9 out of 10 of the Knee Society Scoring System components assessed at 3 months postoperatively, though not all findings were statistically significant. Since this is an early results report, this study will be continued for a longer follow-up, but we are encouraged by these interim results.
本研究的目的是对机器人手臂辅助全膝关节置换术（RATKA）患者和手动全膝关节置换术（TKA）患者的术后结果进行为期3个月的中期比较分析。具体而言，我们根据2011年膝关节协会评分系统评估了：（1）患者自我报告的症状；（2）期望和满意度；（3）功能活动。在2016年6月1日至2018年3月31日期间，252例患者（102例手动置换和150例机器人辅助置换）被纳入一项前瞻性、非随机、开放标签、多中心比较队列研究。术前、术后4至6周以及术后3个月，从2011年膝关节协会评分系统中获取功能活动评分、患者报告的症状以及满意度和期望评分。采用t检验、Wilcoxon秩和检验以及设定α为0.05的卡方检验来比较组间相对于基线的平均改善情况。术后4至6周时，发现RATKA患者在行走和站立方面的改善明显更大（1.4分对 -1.2分；P = 0.019）。与手动TKA患者相比，RATKA患者在高级活动（1.3分对2.3分）、行走疼痛（3.3分对3.2分）、满意度评分（12.4分对12分）以及期望评分（5.1分对4.4分）方面也有更大改善。在3个月时，与手动TKA患者相比，RATKA患者在行走和站立（6.0分对4.8分）、标准活动（11.4分对10.1分）、高级活动（6.2分对4.6分）、功能活动总分（22.8分对21.2分）、行走疼痛（4.3分对4.1分）、总症状评分（10.5分对10.3分）、满意度评分（17.0分对15.5分）、期望评分（4.8分对4.0分）方面也有更大改善。数据表明，在术后3个月评估的膝关节协会评分系统的10个组成部分中，RATKA患者在其中9个方面有相同或更大的改善，尽管并非所有结果都具有统计学意义。由于这是一份早期结果报告，本研究将继续进行更长时间的随访，但这些中期结果让我们备受鼓舞。
