Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania.
Drexel University College of Medicine, Philadelphia, Pennsylvania.
J Arthroplasty. 2022 Nov;37(11):2291-2307.e2. doi: 10.1016/j.arth.2022.05.012. Epub 2022 May 7.
Computer-assisted navigation (CAN) and robotic-assisted (RA) knee arthroplasty procedures carry unique risks of tracking pin-related complications. This systematic review aimed to quantitatively assess the incidence, timing, treatment, and clinical outcomes of all tracking pin-related complications following CAN and RA knee arthroplasty.
A systematic review was performed using PubMed, Cochrane Central and Scopus databases. All clinical studies that documented pin-related complications associated with the use of CAN or RA for total or partial knee arthroplasty were included. Descriptive statistics were analyzed when data were available.
Thirty-six studies were included: 18 case reports (25 cases) and 18 randomized controlled trials, cohort studies and case series i.e., non-case reports (7,336 cases). The most common pin-related complication among case reports was fracture (n = 22; 81%). The overall rate of pin-related complications among non-case reports was 1.4%. The intraoperative and postoperative complication with the highest incidence were pin dislodgement (0.6%) and superficial pin site infections (0.6%), respectively. Most postoperative complications were related to the tibial site (69%). All complications were effectively treated and resolved at follow-up.
Pin-related complications following CAN and RA knee arthroplasty are relatively uncommon. While pin loosening, superficial infections and fractures have been most commonly documented, other complications such as vascular injury, myositis ossificans, and osteomyelitis can also occur. The potential for pin-related complications should be considered by arthroplasty surgeons, especially during early stages of adoption. Further studies investigating patient risk factors for pin-related complications are warranted.
计算机辅助导航（CAN）和机器人辅助（RA）膝关节置换术具有独特的跟踪销钉相关并发症风险。本系统评价旨在定量评估 CAN 和 RA 膝关节置换术后所有跟踪销钉相关并发症的发生率、时间、治疗方法和临床结果。
使用 PubMed、Cochrane 中央和 Scopus 数据库进行系统评价。纳入了所有记录与使用 CAN 或 RA 进行全膝关节或部分膝关节置换术相关的销钉相关并发症的临床研究。当有数据时，采用描述性统计分析。
共纳入 36 项研究：18 例病例报告（25 例）和 18 项随机对照试验、队列研究和病例系列研究（即非病例报告），共 7336 例。病例报告中最常见的销钉相关并发症是骨折（n=22；81%）。非病例报告中销钉相关并发症的总体发生率为 1.4%。术中及术后并发症发生率最高的分别是销钉移位（0.6%）和浅表销钉部位感染（0.6%）。大多数术后并发症与胫骨部位有关（69%）。所有并发症均在随访时得到有效治疗和解决。
CAN 和 RA 膝关节置换术后的销钉相关并发症相对少见。虽然松动、浅表感染和骨折最为常见，但也可能发生血管损伤、骨化性肌炎和骨髓炎等其他并发症。关节置换外科医生应考虑到销钉相关并发症的潜在风险，尤其是在采用新技术的早期阶段。有必要进一步研究患者发生销钉相关并发症的风险因素。
