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机器人辅助全膝关节置换术并不能改善长期临床和影像学结果。

Robot-Assisted Total Knee Arthroplasty Does Not Improve Long-Term Clinical and Radiologic Outcomes.

机构信息

Department of Orthopedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.

Department of Orthopedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea; Department of Orthopaedic Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.

出版信息

J Arthroplasty. 2019 Aug;34(8):1656-1661. doi: 10.1016/j.arth.2019.04.007. Epub 2019 Apr 9.

Abstract

BACKGROUND

Whether robot-assisted total knee arthroplasty (TKA) improves the accuracy of radiographic alignment leading to improved patient satisfaction and implant survivorship in the long term has thus far been inconclusive.

METHODS

We retrospectively compared the long-term clinical and radiological outcomes of 84 knees that had undergone robot-assisted TKA using ROBODOC vs 79 knees that had undergone conventional TKA. The mean duration of the follow-up period was 129.1 months (range: 108-147 months). Clinical outcomes were evaluated using the Knee Society Score and 36-item Short Form Survey, as well as by assessing the range of motion, operation time, and complications. Radiologic outcomes were evaluated by assessing the hip-knee-ankle angle, coronal and sagittal alignments of the femoral and tibial components, and any radiologic abnormalities such as loosening or osteolysis.

RESULTS

There was no significant difference in clinical outcomes between the two groups. The prevalence of an outlier for the hip-knee-ankle angle in the robot-assisted group was 10.7%, whereas it was 16.5% in the conventional group (P = .172). The other component alignments (α°, β°, γ°, δ°) revealed a tendency toward a lower rate of outliers in the robot-assisted group, but without statistical significance (P > .05). In addition, there was no significant difference in complications, including revision surgery, between both groups.

CONCLUSION

Robot-assisted TKA does not improve long-term clinical or radiologic outcomes compared with conventional TKA.

摘要

背景

机器人辅助全膝关节置换术(TKA)是否能提高放射学对线的准确性,从而提高患者满意度和长期植入物存活率,目前尚无定论。

方法

我们回顾性比较了 84 例使用 ROBODOC 行机器人辅助 TKA 和 79 例常规 TKA 的膝关节的长期临床和放射学结果。平均随访时间为 129.1 个月(范围:108-147 个月)。临床结果采用膝关节协会评分和 36 项简短表格调查进行评估,并评估了关节活动度、手术时间和并发症。放射学结果通过评估髋膝踝角、股骨和胫骨组件的冠状和矢状对线以及任何放射学异常(如松动或骨溶解)进行评估。

结果

两组患者的临床结果无显著差异。机器人辅助组髋关节-膝关节-踝关节角度的离群值发生率为 10.7%,而常规组为 16.5%(P=.172)。其他组件对线(α°、β°、γ°、δ°)显示机器人辅助组的离群值发生率较低,但无统计学意义(P>.05)。此外,两组的并发症(包括翻修手术)发生率无显著差异。

结论

与常规 TKA 相比,机器人辅助 TKA 并不能改善长期的临床或放射学结果。

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