Department of Orthopaedic Surgery, Hannover Medical School, Diakovere Annastift, Anna von Borries Str. 1-6, 30625, Hannover, Germany.
London North West University Healthcare NHS Trust, Acton Lane Park Royal, London, UK.
Orthopade. 2021 Dec;50(12):1018-1025. doi: 10.1007/s00132-021-04182-w. Epub 2021 Oct 29.
It is evident from the national joint registries that numbers of revision knee arthroplasty operations are rising. The aim of this article is to introduce a new robotic-assisted approach in UKA to TKA revision arthroplasty and investigate the alignment accuracy, implant component use and surgery time and to compare it to primary robotic-assisted TKA arthroplasty.
This retrospective, case-control study included patients undergoing image-less robotic-assisted revision arthroplasty from UKA to TKA (n = 20) and patients undergoing image-less robotic-assisted primary TKA (control group, n = 20) from 11/2018 to 07/2020. The control group was matched based on the BMI and natural alignment. Comparison of groups was based on postoperative alignment, outlier rate, tibial insert size, lateral bone resection depth, incision-to-wound closure time. All surgeries were performed by a single senior surgeon using the same bi-cruciate stabilizing TKA system. Statistical analysis consisted of parametric t‑testing and Fisher's exact test with a level of significance of p < 0.05.
The two groups showed no differences in mean BMI, natural alignment (p > 0.05) and mean overall limb alignment. No outlier was found for OLA and slope analysis. The smallest insert size (9 mm) was used in 70% of the cases in the revision group (n = 14) and in 90% of the cases in the primary group (n = 18, p = 0.24), distal femoral and tibial resection depth showed no statistical difference (p > 0.05). The incision to wound closure time was longer in the revision group but showed no significant difference.
Image-less robotic-assisted revision arthroplasty from UKA to TKA showed a comparable surgery time, and alignment accuracy in comparison to primary robotic-assisted TKA. Comparable bone preservation and subsequent tibial insert size use was observed for both groups.
国家联合登记处的数据表明，膝关节翻修手术的数量正在增加。本文旨在介绍一种新的机器人辅助 UKA 至 TKA 翻修关节置换术的方法，并研究其对线准确性、植入物组件的使用以及手术时间，并与原发性机器人辅助 TKA 关节置换术进行比较。
本回顾性病例对照研究纳入了 2018 年 11 月至 2020 年 7 月期间接受无影像机器人辅助翻修术（从 UKA 到 TKA）的患者（n=20）和接受无影像机器人辅助原发性 TKA（对照组，n=20）的患者。对照组根据 BMI 和自然对线进行匹配。基于术后对线、离群率、胫骨衬垫大小、外侧骨切除深度、切口至伤口关闭时间对两组进行比较。所有手术均由一位资深外科医生使用相同的双交叉稳定 TKA 系统进行。统计分析包括参数 t 检验和 Fisher 精确检验，显著性水平为 p<0.05。
两组在平均 BMI、自然对线（p>0.05）和平均整体肢体对线方面无差异。在 OLA 和斜率分析中没有发现离群值。在翻修组中，70%的病例（n=14）使用了最小的衬垫尺寸（9mm），而在原发性组中，90%的病例（n=18，p=0.24）使用了最小的衬垫尺寸，股骨远端和胫骨切除深度无统计学差异（p>0.05）。翻修组的切口至伤口关闭时间较长，但无显著差异。
与原发性机器人辅助 TKA 相比，无影像机器人辅助 UKA 至 TKA 翻修术的手术时间和对线准确性相当。两组均观察到相似的骨保留和随后胫骨衬垫尺寸的使用。
