Marchand Kevin B, Moody Rachel, Scholl Laura Y, Bhowmik-Stoker Manoshi, Taylor Kelly B, Mont Michael A, Marchand Robert C
Department of Orthopaedic Surgery, Northwell Health Orthopedics at Lenox Hill Hospital, New York, New York.
Department of Orthopaedic Surgery, South County Orthopaedics, Orthopaedics Rhode Island, Wakefield, Rhode Island.
J Knee Surg. 2023 Jan;36(2):159-166. doi: 10.1055/s-0041-1731349. Epub 2021 Jun 29.
Robotic-assisted technology has been developed to optimize the consistency and accuracy of bony cuts, implant placements, and knee alignments for total knee arthroplasty (TKA). With recently developed designs, there is a need for the reporting longer than initial patient outcomes. Therefore, the purpose of this study was to compare manual and robotic-assisted TKA at 2-year minimum for: (1) aseptic survivorship; (2) reduced Western Ontario and McMaster Universities Osteoarthritis Index (r-WOMAC) pain, physical function, and total scores; (3) surgical and medical complications; and (4) radiographic assessments for progressive radiolucencies. We compared 80 consecutive cementless robotic-assisted to 80 consecutive cementless manual TKAs. Patient preoperative r-WOMAC and demographics (e.g., age, sex, and body mass index) were not found to be statistically different. Surgical data and medical records were reviewed for aseptic survivorship, medical, and surgical complications. Patients were administered an r-WOMAC survey preoperatively and at 2-year postoperatively. Mean r-WOMAC pain, physical function, and total scores were tabulated and compared using Student's -tests. Radiographs were reviewed serially throughout patient's postoperative follow-up. A < 0.05 was considered significant. The aseptic failure rates were 1.25 and 5.0% for the robotic-assisted and manual cohorts, respectively. Patients in the robotic-assisted cohort had significantly improved 2-year postoperative r-WOMAC mean pain (1 ± 2 vs. 2 ± 3 points, = 0.02), mean physical function (2 ± 3 vs. 4 ± 5 points, = 0.009), and mean total scores (4 ± 5 vs, 6 ± 7 points, = 0.009) compared with the manual TKA. Surgical and medical complications were similar in the two cohorts. Only one patient in the manual cohort had progressive radiolucencies on radiographic assessment. Robotic-assisted TKA patients demonstrated improved 2-year postoperative outcomes when compared with manual patients. Further studies could include multiple surgeons and centers to increase the generalizability of these results. The results of this study indicate that patients who undergo robotic-assisted TKA may have improved 2-year postoperative outcomes.
机器人辅助技术已得到发展，以优化全膝关节置换术（TKA）中骨切割、植入物放置和膝关节对线的一致性和准确性。随着最近开发的设计，需要报告比最初患者结局更长时间的情况。因此，本研究的目的是至少在2年时比较手动和机器人辅助TKA在以下方面的情况：（1）无菌生存率；（2）西部安大略和麦克马斯特大学骨关节炎指数（r-WOMAC）疼痛、身体功能和总分降低情况；（3）手术和医疗并发症；（4）进行性透亮线的影像学评估。我们将80例连续的非骨水泥机器人辅助TKA与80例连续的非骨水泥手动TKA进行了比较。未发现患者术前r-WOMAC和人口统计学特征（如年龄、性别和体重指数）存在统计学差异。回顾手术数据和医疗记录以了解无菌生存率、医疗和手术并发症情况。患者在术前和术后2年接受r-WOMAC调查。将r-WOMAC疼痛、身体功能和总分的平均值制成表格，并使用学生t检验进行比较。在患者术后随访期间连续复查X线片。P < 0.05被认为具有统计学意义。机器人辅助组和手动组的无菌失败率分别为1.25%和5.0%。与手动TKA相比，机器人辅助组患者术后2年的r-WOMAC平均疼痛（1±2分对2±3分，P = 0.02）、平均身体功能（2±3分对4±5分，P = 0.009）和平均总分（4±5分对6±7分，P = 0.009）有显著改善。两组的手术和医疗并发症相似。手动组中只有1例患者在影像学评估中有进行性透亮线。与手动组患者相比，机器人辅助TKA患者术后2年的结局有所改善。进一步的研究可纳入多名外科医生和多个中心，以提高这些结果的普遍性。本研究结果表明，接受机器人辅助TKA的患者术后2年的结局可能会有所改善。
