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对于孤立性内侧间室关节炎,与人工全膝关节置换术相比,机器人辅助单髁膝关节置换术具有更好的早期功能结果。

Robotic-assisted unicompartmental knee arthroplasty has a greater early functional outcome when compared to manual total knee arthroplasty for isolated medial compartment arthritis.

作者信息

Clement N D, Bell A, Simpson P, Macpherson G, Patton J T, Hamilton D F

机构信息

Department of Orthopaedics and Trauma, The Royal Infirmary of Edinburgh, Edinburgh, UK.

Spire Murrayfield Hospital, Edinburgh, UK.

出版信息

Bone Joint Res. 2020 May 16;9(1):15-22. doi: 10.1302/2046-3758.91.BJR-2019-0147.R1. eCollection 2020 Jan.

Abstract

AIMS

The primary aim of the study was to compare the knee-specific functional outcome of robotic unicompartmental knee arthroplasty (rUKA) with manual total knee arthroplasty (mTKA) for the management of isolated medial compartment osteoarthritis. Secondary aims were to compare length of hospital stay, general health improvement, and satisfaction between rUKA and mTKA.

METHODS

A powered (1:3 ratio) cohort study was performed. A total of 30 patients undergoing rUKA were propensity score matched to 90 patients undergoing mTKA for isolated medial compartment arthritis. Patients were matched for age, sex, body mass index (BMI), and preoperative function. The Oxford Knee Score (OKS) and EuroQol five-dimension questionnaire (EQ-5D) were collected preoperatively and six months postoperatively. The Forgotten Joint Score (FJS) and patient satisfaction were collected six months postoperatively. Length of hospital stay was also recorded.

RESULTS

There were no significant differences in the preoperative demographics (p ⩾ 0.150) or function (p ⩾ 0.230) between the groups. The six-month OKS was significantly greater in the rUKA group when compared with the mTKA group (difference 7.7, p < 0.001). There was also a greater six-month postoperative EQ-5D (difference 0.148, p = 0.002) and FJS (difference 24.2, p < 0.001) for the rUKA when compared to the mTKA. No patient was dissatisfied in the rUKA group and five (6%) were dissatisfied in the mTKA, but this was not significant (p = 0.210). Length of stay was significantly (p < 0.001) shorter in the rUKA group (median two days, interquartile range (IQR) 1 to 3) compared to the mTKA (median four days, IQR 3 to 5).

CONCLUSION

Patients with isolated medial compartment arthritis had a greater knee-specific functional outcome and generic health with a shorter length of hospital stay after rUKA when compared to mTKA.Cite this article: 2019;9(1):15-22.

摘要

目的

本研究的主要目的是比较机器人单髁膝关节置换术(rUKA)与手动全膝关节置换术(mTKA)治疗单纯内侧间室骨关节炎的膝关节特定功能结局。次要目的是比较rUKA和mTKA之间的住院时间、总体健康改善情况和患者满意度。

方法

进行了一项有动力的(1:3比例)队列研究。总共30例行rUKA的患者与90例行mTKA治疗单纯内侧间室关节炎的患者进行倾向评分匹配。患者在年龄、性别、体重指数(BMI)和术前功能方面进行匹配。术前和术后6个月收集牛津膝关节评分(OKS)和欧洲五维健康量表(EQ-5D)。术后6个月收集遗忘关节评分(FJS)和患者满意度。同时记录住院时间。

结果

两组患者术前人口统计学特征(p⩾0.150)或功能(p⩾0.230)无显著差异。与mTKA组相比,rUKA组术后6个月的OKS显著更高(差异为7.7,p<0.001)。与mTKA相比,rUKA术后6个月的EQ-5D(差异为0.148,p = 0.002)和FJS(差异为24.2,p<0.001)也更高。rUKA组无患者不满意,mTKA组有5例(6%)不满意,但差异无统计学意义(p = 0.210)。与mTKA组(中位数4天,四分位间距(IQR)3至5天)相比,rUKA组住院时间显著缩短(p<0.001)(中位数2天,IQR 1至3天)。

结论

与mTKA相比,单纯内侧间室关节炎患者行rUKA后膝关节特定功能结局更好且总体健康状况更佳,住院时间更短。引用本文:2019;9(1):15-22。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1673/7229306/82a2b82c8207/bonejointres-09-15-g001.jpg

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