Marchand Robert C, Sodhi Nipun, Anis Hiba K, Ehiorobo Joseph, Newman Jared M, Taylor Kelly, Condrey Caitlin, Hepinstall Matthew S, Mont Michael A
Department of Orthopaedic Surgery, Ortho Rhode Island, Wakefield, Rhode Island.
Department of Orthopaedic Surgery, Lenox Hill Hospital Northwell Health, New York, New York.
J Knee Surg. 2019 Nov;32(11):1063-1068. doi: 10.1055/s-0039-1683977. Epub 2019 Apr 8.
Although there are many studies on the alignment advantages when using the robotic arm-assisted (RAA) system for total knee arthroplasty (TKA), there have been questions regarding patient-reported outcomes. Therefore, the purpose of this study was to use this index to compare: (1) total, (2) physical function, and (3) pain scores for manual versus RAA patients. We compared 53 consecutive RAA to 53 consecutive manual TKAs. No differences in preoperative scores were found between the cohorts. Patients were administered a modified Western Ontario and McMaster Universities Osteoarthritis Index satisfaction survey preoperatively and at 1-year postoperatively. The results were broken down to: (1) total, (2) physical function, and (3) pain scores. Univariate analysis with independent samples -tests was used to compare 1-year postoperative scores. Multivariate models with stepwise backward linear regression were utilized to evaluate the associations between scores and surgical technique, age, sex, as well as body mass index (BMI). Statistical analyses were performed with a < 0.05 to determine significance. The RAA cohort had significantly improved mean total (6 ± 6 vs. 9 ± 8 points, = 0.03) and physical function scores (4 ± 4 vs. 6 ± 5 points, = 0.02) when compared with the manual cohort. The mean pain score for the RAA cohort (2 ± 3 points [range, 0-14 points]) was also lower than that for the manual cohort (3 ± 4 points [range, 0-11 points]) ( = 0.06). On backward linear regression analyses, RAA was found to be significantly associated with more improved total (β coefficient [β] -0.208, standard error [SE] 1.401, < 0.05), function (β = 0.216, SE = 0.829, < 0.05), and pain scores (β -0.181, SE = 0.623, = 0.063). The RAA technique was found to have the strongest association with improved scores when compared with age, gender, and BMI. This study suggests that RAA patients may have short-term improvements at minimum 1-year postoperatively. However, longer term follow-up with greater sample sizes is needed to further validate these results.
尽管有许多关于使用机器人手臂辅助（RAA）系统进行全膝关节置换术（TKA）时对线优势的研究，但患者报告的结局一直存在疑问。因此，本研究的目的是使用该指标比较：（1）总体、（2）身体功能以及（3）手动手术与RAA手术患者的疼痛评分。我们将连续53例RAA手术患者与连续53例手动TKA手术患者进行了比较。两组术前评分未发现差异。患者在术前和术后1年接受了改良的西安大略和麦克马斯特大学骨关节炎指数满意度调查。结果分为：（1）总体、（2）身体功能以及（3）疼痛评分。使用独立样本t检验进行单因素分析以比较术后1年的评分。采用逐步向后线性回归的多变量模型来评估评分与手术技术、年龄、性别以及体重指数（BMI）之间的关联。进行统计分析时设定P＜0.05以确定显著性。与手动手术组相比，RAA手术组的平均总体评分（6±6分对9±8分，P = 0.03）和身体功能评分（4±4分对6±5分，P = 0.02）有显著改善。RAA手术组的平均疼痛评分（2±3分[范围，0 - 14分]）也低于手动手术组（3±4分[范围，0 - 11分]）（P = 0.06）。在向后线性回归分析中，发现RAA与总体评分改善更多（β系数[β] -0.208，标准误[SE] 1.401，P＜0.05）、功能评分改善（β = 0.216，SE = 0.829，P＜0.05）以及疼痛评分改善（β -0.181，SE = 0.623，P = 0.063）显著相关。与年龄、性别和BMI相比，发现RAA技术与评分改善的关联最强。本研究表明，RAA手术患者术后至少1年可能有短期改善。然而，需要更大样本量的长期随访来进一步验证这些结果。
