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无影像机器人辅助全膝关节置换术与传统全膝关节置换术相比,24 个月时 WOMAC 评分相似:一项回顾性队列研究。

Imageless robotic-assisted total knee arthroplasty leads to similar 24-month WOMAC scores as compared to conventional total knee arthroplasty: a retrospective cohort study.

机构信息

Department of Orthopedic Surgery, Columbia University Medical Center, 630 West 168th Street, PH-11, New York, NY, 10032, USA.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2022 Aug;30(8):2631-2638. doi: 10.1007/s00167-021-06599-4. Epub 2021 May 7.

DOI:10.1007/s00167-021-06599-4
PMID:33961067
Abstract

PURPOSE

Robotic-assisted total knee arthroplasty (RA-TKA) was introduced to improve limb alignment, component positioning, soft-tissue balance and to minimize surgical outliers. This study investigates perioperative outcomes, complications, and early patient-reported outcome measures (PROMs) of one imageless RA-TKA system compared to conventional method TKA (CM-TKA) at 24-month follow-up.

METHODS

This multi-surgeon retrospective cohort analysis compared 111 imageless RA-TKA patients to 110 CM-TKA patients (n = 221). Basic demographic information, intraoperative and postoperative data, and PROMs, including the functional score of the Knee Society Score (KSS-FS), The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Short Form 12 Mental and Physical scores (SF-12M and P), were collected and recorded preoperatively, at 3-, 12- and 24-months postoperatively. Range of motion (ROM), estimated blood loss (EBL), surgical duration, and complications were also collected.

RESULTS

There were no baseline patient demographic differences between groups. EBL (240 vs. 190 mL, p < 0.001) and surgical duration (123 vs. 107 min, p < 0.001) were significantly greater in RA-TKA. There were no significant differences in postoperative complications, ROM, length of stay (LOS), and PROMs between cohorts at 3-, 12-, 24-months postoperatively.

CONCLUSIONS

Imageless RA-TKA is associated with greater EBL and surgical duration compared to CM-TKA. However, at 24-month follow-up, there were no significant differences in ROM, LOS, complications and PROMs between cohorts. Imageless robotic surgery leads to similar 24-month clinical outcomes as compared to CM-TKA.

LEVEL OF EVIDENCE

III.

摘要

目的

机器人辅助全膝关节置换术(RA-TKA)的引入旨在改善肢体对线、假体位置、软组织平衡,并最大限度地减少手术 outliers。本研究旨在比较一种无图像 RA-TKA 系统与传统方法 TKA(CM-TKA)在 24 个月随访时的围手术期结果、并发症和早期患者报告的结果测量(PROMs)。

方法

本多外科医生回顾性队列分析比较了 111 例无图像 RA-TKA 患者和 110 例 CM-TKA 患者(n=221)。收集并记录了基本人口统计学信息、术中及术后数据以及 PROMs,包括膝关节学会评分(KSS-FS)的功能评分、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)以及短表单 12 心理和生理评分(SF-12M 和 P),分别在术前、术后 3、12 和 24 个月进行评估。还收集了关节活动度(ROM)、估计失血量(EBL)、手术时间和并发症。

结果

两组患者在基线人口统计学特征方面无差异。RA-TKA 组的 EBL(240 比 190ml,p<0.001)和手术时间(123 比 107 分钟,p<0.001)明显更长。两组患者在术后并发症、ROM、住院时间(LOS)和 PROMs 方面在术后 3、12 和 24 个月均无显著差异。

结论

与 CM-TKA 相比,无图像 RA-TKA 与更大的 EBL 和手术时间相关。然而,在 24 个月的随访中,两组患者在 ROM、LOS、并发症和 PROMs 方面无显著差异。无图像机器人手术与 CM-TKA 相比,可获得相似的 24 个月临床结果。

证据水平

III。

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