Kazarian Gregory S, Barrack Robert L, Barrack Toby N, Lawrie Charles M, Nunley Ryan M
Department of Orthopaedic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St. Louis, Missouri, USA.
Hospital for Special Surgery, New York, New York, USA.
Bone Jt Open. 2021 Mar;2(3):191-197. doi: 10.1302/2633-1462.23.BJO-2020-0205.R1.
The purpose of this study was to compare the radiological outcomes of manual versus robotic-assisted medial unicompartmental knee arthroplasty (UKA).
Postoperative radiological outcomes from 86 consecutive robotic-assisted UKAs (RAUKA group) from a single academic centre were retrospectively reviewed and compared to 253 manual UKAs (MUKA group) drawn from a prior study at our institution. Femoral coronal and sagittal angles (FCA, FSA), tibial coronal and sagittal angles (TCA, TSA), and implant overhang were radiologically measured to identify outliers.
When assessing the accuracy of RAUKAs, 91.6% of all alignment measurements and 99.2% of all overhang measurements were within the target range. All alignment and overhang targets were simultaneously met in 68.6% of RAUKAs. When comparing radiological outcomes between the RAUKA and MUKA groups, statistically significant differences were identified for combined outliers in FCA (2.3% vs 12.6%; p = 0.006), FSA (17.4% vs 50.2%; p < 0.001), TCA (5.8% vs 41.5%; p < 0.001), and TSA (8.1% vs 18.6%; p = 0.023), as well as anterior (0.0% vs 4.7%; p = 0.042), posterior (1.2% vs 13.4%; p = 0.001), and medial (1.2% vs 14.2%; p < 0.001) overhang outliers.
Robotic system navigation decreases alignment and overhang outliers compared to manual UKA. Given the association between component placement errors and revision in UKA, this strong significant improvement in accuracy may improve implant survival. Level of Evidence: III Cite this article: 2021;2-3:191-197.
本研究旨在比较手动与机器人辅助内侧单髁膝关节置换术（UKA）的影像学结果。
回顾性分析来自单一学术中心的86例连续机器人辅助UKA（RAUKA组）的术后影像学结果，并与本机构先前一项研究中的253例手动UKA（MUKA组）进行比较。通过影像学测量股骨冠状面和矢状面角度（FCA、FSA）、胫骨冠状面和矢状面角度（TCA、TSA）以及植入物悬垂，以识别异常值。
在评估RAUKA的准确性时，所有对线测量的91.6%和所有悬垂测量的99.2%在目标范围内。68.6%的RAUKA同时满足所有对线和悬垂目标。在比较RAUKA组和MUKA组的影像学结果时，发现FCA（2.3%对12.6%；p = 0.006）、FSA（17.4%对50.2%；p < 0.001）、TCA（5.8%对41.5%；p < 0.001）和TSA（8.1%对18.6%；p = 0.023）的合并异常值以及前侧（0.0%对4.7%；p = 0.042）、后侧（1.2%对13.4%；p = 0.001）和内侧（1.2%对14.2%；p < 0.001）悬垂异常值存在统计学显著差异。
与手动UKA相比，机器人系统导航减少了对线和悬垂异常值。鉴于UKA中组件放置误差与翻修之间的关联，这种准确性的显著提高可能会改善植入物的生存率。证据级别：III引用本文：2021；2 - 3：191 - 197。
