比较单髁膝关节置换术机器人辅助手术中的不同方法:MAKO 与 NAVIO 系统的短期随访结果。
Comparing different approaches in robotic-assisted surgery for unicompartmental knee arthroplasty: outcomes at a short-term follow-up of MAKO versus NAVIO system.
机构信息
Department of Orthopaedic and Traumatology, San Luigi Gonzaga Hospital, Orbassano, University of Torino, Torino, Italy.
C.T.O. Centro Traumatologico Ortopedico di Torino, Department of Orthopaedic and Traumatology, University of Torino, Torino, Italy.
出版信息
J Biol Regul Homeost Agents. 2020 Jul-Aug;34(4 Suppl. 3):393-404. Congress of the Italian Orthopaedic Research Society.
The popularity of unicompartmental knee arthroplasty (UKA) continues to grow among orthopaedic surgeons and robotic surgery may be helpful in obtaining a precise placement of the prosthetic components, thanks to the meticulous intra-operative computer study for simulating the prosthetic positioning. This may lead to longer implant survivorship as well as a reduction in intermediate and long-term prosthetic complications, despite the initial greater costs than those of manual UKA. In this preliminary study, from January 2017 and October 2017, 18 patients underwent UKA with MAKO robotic system assistance and 10 patients received UKA with NAVIO robotic system assistance. The two groups were homogeneous by age, BMI, degree of osteoarthritis involvement, and postoperative program. Patients were followed both clinically (Numeric Rating Scale NRS and Knee Injury Osteoarthritis Outcome Scores KOOS) and radiographically. At the end term follow up (2 years), no significant difference was observed for NRS and KOOS as well as for clinical parameters as an active range of motion. A significant discrepancy was detected regarding the duration of the surgery and time of using the robotic system, that appeared to be longer in the NAVIO group than that of MAKO group, likely due to the specific technical aspects that characterize these two different robotic systems. The main finding of this study is that favorable clinical and radiographical results may be obtained using a robotic approach (MAKO or NAVIO) for UKA positioning at a short follow up. Due to the lack of significant clinical differences observed between the two groups of patients at end term follow up, the "concept" of a robotic approach, more than a specific patented system, may be considered the key element for improving UKA technique and it is likely that in the near future the choice of a single specific robotic system will still be a "surgeon's preference". The results of the study add scientific evidence regarding the effective improvement of UKA results using different robotic approaches. They also show possible economic sustainability of this therapeutic strategy related to the optimal patients' performance obtained at short term follow up, suggesting that the robotic assistance may really become a key element for better long-term survivorship of unicompartmental knee arthroplasty.
单髁膝关节置换术(UKA)在骨科医生中越来越受欢迎,机器人手术可能有助于通过精细的术中计算机研究来模拟假体定位,从而更精确地放置假体部件。这可能会导致假体存活率更高,中期和长期假体并发症减少,尽管初始成本高于手动 UKA。在这项初步研究中,2017 年 1 月至 2017 年 10 月,18 例患者接受了 MAKO 机器人系统辅助下的 UKA,10 例患者接受了 NAVIO 机器人系统辅助下的 UKA。两组在年龄、BMI、骨关节炎受累程度和术后方案方面具有同质性。患者接受了临床(数字评分量表 NRS 和膝关节损伤骨关节炎结果评分 KOOS)和影像学随访。在最终随访(2 年)时,NRS 和 KOOS 以及临床参数(主动活动范围)均无显著差异。手术时间和机器人系统使用时间存在显著差异,NAVIO 组似乎比 MAKO 组长,这可能是由于这两种不同的机器人系统具有特定的技术特点。本研究的主要发现是,在短期随访中,使用机器人方法(MAKO 或 NAVIO)进行 UKA 定位可能获得良好的临床和影像学结果。由于在最终随访时,两组患者之间没有观察到明显的临床差异,因此“机器人方法”的概念(MAKO 或 NAVIO)可能比特定的专利系统更重要,它可能是提高 UKA 技术的关键因素,而且在不久的将来,选择单一的特定机器人系统仍将是“医生的偏好”。该研究的结果提供了关于使用不同机器人方法有效改善 UKA 结果的科学证据。它们还表明,与短期随访获得的最佳患者表现相关,这种治疗策略具有一定的经济可持续性,这表明机器人辅助治疗可能确实成为提高单髁膝关节置换术长期存活率的关键因素。