Begum Fahima A, Kayani Babar, Morgan Samuel D J, Ahmed Syed S, Singh Sandeep, Haddad Fares S
University College Hospital, London, UK.
EFORT Open Rev. 2020 May 5;5(5):312-318. doi: 10.1302/2058-5241.5.190089. eCollection 2020 May.
Unicompartmental knee arthroplasty (UKA) is associated with improved functional outcomes but reduced implant survivorship compared to total knee arthroplasty (TKA).Surgeon-controlled errors in component positioning are the most common reason for implant failure in UKA, and low UKA case-volume is associated with poor implant survivorship and earlier time to revision surgery.Robotic UKA is associated with improved accuracy of achieving the planned femoral and tibial component positioning compared to conventional manual UKA.Robotic UKA has a learning curve of six operative cases for achieving operative times and surgical team comfort levels comparable to conventional manual UKA, but there is no learning curve effect for accuracy of implant positioning or limb alignment.Robotic UKA is associated with reduced postoperative pain, decreased opiate analgesia requirements, faster inpatient rehabilitation, and earlier time to hospital discharge compared to conventional manual UKA.Limitations of robotic UKA include high installation costs, additional radiation exposure with image-based systems, and paucity of studies showing any long-term differences in functional outcomes or implant survivorship compared to conventional manual UKA.Further clinical studies are required to establish how statistical differences in accuracy of implant positioning between conventional manual UKA and robotic UKA translate to long-term differences in functional outcomes, implant survivorship, complications, and cost-effectiveness. Cite this article: 2020;5:312-318. DOI: 10.1302/2058-5241.5.190089.
与全膝关节置换术(TKA)相比,单髁膝关节置换术(UKA)能带来更好的功能结果,但植入物生存率较低。外科医生控制的组件定位误差是UKA植入物失败的最常见原因,而UKA低手术量与植入物生存率低和翻修手术时间早相关。与传统手动UKA相比,机器人辅助UKA在实现计划的股骨和胫骨组件定位方面具有更高的准确性。机器人辅助UKA在达到与传统手动UKA相当的手术时间和手术团队舒适度方面有一个六例手术的学习曲线,但在植入物定位准确性或肢体对线方面没有学习曲线效应。与传统手动UKA相比,机器人辅助UKA术后疼痛减轻、阿片类镇痛药物需求减少、住院康复更快且出院时间更早。机器人辅助UKA的局限性包括安装成本高、基于图像的系统会增加辐射暴露,以及与传统手动UKA相比,缺乏显示功能结果或植入物生存率有任何长期差异的研究。需要进一步的临床研究来确定传统手动UKA和机器人辅助UKA在植入物定位准确性上的统计学差异如何转化为功能结果、植入物生存率、并发症和成本效益方面的长期差异。引用本文:2020;5:312 - 318。DOI: