Department of Orthopedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625, Hanover, Germany.
Articon CHRISTENORTO AG, Schänzlistrasse 39, 3013, Bern, Switzerland.
Arch Orthop Trauma Surg. 2021 Dec;141(12):2139-2146. doi: 10.1007/s00402-021-04114-5. Epub 2021 Aug 18.
It is known that in uni-compartmental knee arthroplasty (UKA) low-volume surgeons have a higher complication and revision rate than high-volume surgeons. Further, robotic-assisted UKA leads to lower early revision rate as well as fewer limb and joint line outliers compared to conventional UKA. The purpose of this study was to retrospectively analyze the outliers' and revision rate of low-volume UKA surgeons with different robotic systems at short-term follow-up.
In this case-control study, 103 robotic-assisted UKAs were included. The procedures were performed between 2016 and 2019 from two low-volume UKA surgeons with an imageless (IL) (63 patients) and image-based (IB) (40 patients) robotic system. Alignment outliers, joint line (JL) reconstruction, complication and revision rates of the two different robotic systems were analyzed. The minimum follow-up was two years. Outliers were defined as a postoperative valgus malalignment greater than 182°. The surgery time for all procedures was evaluated.
The overall revision rate was 3.9% (4 of 103). Two occurred in the IB group (5.0%) and two in the IL group (3.2%). No valgus malalignment outliers were observed in both groups. The mean JL was not distalized by more than 2 mm in both groups (IL: 1.3 ± 1.6 mm vs. IB: 1.8 ± 0.9 mm, p value 0.08). The IL procedures had a significant lower mean surgery time (55 ± 13 min vs. 68 ± 14, p value 0.001).
Robotic-assisted UKA is a safe procedure in the hand of low-volume UKA surgeons. Robotic-assisted UKA minimizes overcorrection into valgus mal-alignment. Low revision rates are observed at short-term follow-up for robotic-assisted UKA. The choice of the different robotic systems has no impact on the outcome.
众所周知，在单髁膝关节置换术（UKA）中，低年资医生的并发症和翻修率高于高年资医生。此外，与传统 UKA 相比，机器人辅助 UKA 可降低早期翻修率以及肢体和关节线的偏差。本研究旨在回顾性分析短期随访中不同机器人系统的低年资 UKA 医生的偏差和翻修率。
在这项病例对照研究中，纳入了 103 例机器人辅助 UKA。这些手术是由两位低年资 UKA 医生于 2016 年至 2019 年期间进行的，分别使用无图像（IL）（63 例）和基于图像（IB）（40 例）机器人系统。分析了两种不同机器人系统的对线偏差、关节线（JL）重建、并发症和翻修率。所有手术的最短随访时间为两年。偏差定义为术后外翻角大于 182°。评估了所有手术的手术时间。
总的翻修率为 3.9%（103 例中的 4 例）。2 例发生在 IB 组（5.0%），2 例发生在 IL 组（3.2%）。两组均未观察到外翻角偏差。两组的平均 JL 均未向远端移位超过 2mm（IL：1.3±1.6mm vs. IB：1.8±0.9mm，p 值 0.08）。IL 组的平均手术时间明显较短（55±13 分钟 vs. 68±14 分钟，p 值 0.001）。
机器人辅助 UKA 是低年资 UKA 医生安全的手术方法。机器人辅助 UKA 最大限度地减少了过度矫正成外翻角对线不良。在短期随访中，机器人辅助 UKA 的翻修率较低。不同机器人系统的选择对结果没有影响。
