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机器人辅助双单间膝关节置换术与全膝关节置换术的早期结果比较:一项前瞻性、随机对照试验。

Early outcomes after robotic arm-assisted bi-unicompartmental knee arthroplasty compared with total knee arthroplasty: a prospective, randomized controlled trial.

机构信息

Department of Trauma and Orthopaedics, Glasgow Royal Infirmary, Glasgow, UK.

Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK.

出版信息

Bone Joint J. 2021 Oct;103-B(10):1561-1570. doi: 10.1302/0301-620X.103B10.BJJ-2020-1919.R2.

Abstract

AIMS

The aim of this study was to compare the clinical outcomes of robotic arm-assisted bi-unicompartmental knee arthroplasty (bi-UKA) with conventional mechanically aligned total knee arthroplasty (TKA) during the first six weeks and at one year postoperatively.

METHODS

A per protocol analysis of 76 patients, 43 of whom underwent TKA and 34 of whom underwent bi-UKA, was performed from a prospective, single-centre, randomized controlled trial. Diaries kept by the patients recorded pain, function, and the use of analgesics daily throughout the first week and weekly between the second and sixth weeks. Patient-reported outcome measures (PROMs) were compared preoperatively, and at three months and one year postoperatively. Data were also compared longitudinally and a subgroup analysis was conducted, stratified by preoperative PROM status.

RESULTS

Both operations were shown to offer comparable outcomes, with no significant differences between the groups across all timepoints and outcome measures. Both groups also had similarly low rates of complications. Subgroup analysis for preoperative psychological state, activity levels, and BMI showed no difference in outcomes between the two groups.

CONCLUSION

Robotic arm-assisted, cruciate-sparing bi-UKA offered similar early clinical outcomes and rates of complications to a mechanically aligned TKA, both in the immediate postoperative period and up to one year following surgery. Further work is required to identify which patients with osteoarthritis of the knee will derive benefit from a cruciate-sparing bi-UKA. Cite this article:  2021;103-B(10):1561-1570.

摘要

目的

本研究旨在比较机器人辅助双间室膝关节置换术(bi-UKA)与传统机械对线全膝关节置换术(TKA)在术后前 6 周和 1 年的临床结果。

方法

对一项前瞻性、单中心、随机对照试验中的 76 例患者(其中 43 例行 TKA,34 例行 bi-UKA)进行协议分析。患者日记记录了术后第一周每天和第二周至第六周每周的疼痛、功能和镇痛药使用情况。比较术前、术后 3 个月和 1 年的患者报告的结果测量(PROM)。还进行了纵向数据比较,并进行了亚组分析,按术前 PROM 状态分层。

结果

两种手术均显示出相似的结果,在所有时间点和所有结果测量中,两组之间均无显著差异。两组的并发症发生率也相似。术前心理状态、活动水平和 BMI 的亚组分析显示,两组之间的结果无差异。

结论

在术后即刻和 1 年随访期间,机器人辅助、保留交叉韧带的 bi-UKA 与机械对线 TKA 具有相似的早期临床结果和并发症发生率。需要进一步研究以确定哪些膝关节骨关节炎患者将从保留交叉韧带的 bi-UKA 中获益。

引用本文

2021;103-B(10):1561-1570。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc5f/9948427/748019a56270/BJJ-103B-1561-g0001.jpg

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