Department of Knee Surgery, Policlinico Abano Terme, Abano Terme, Italy.
Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
Knee Surg Sports Traumatol Arthrosc. 2023 Mar;31(3):1063-1071. doi: 10.1007/s00167-022-07218-6. Epub 2022 Nov 14.
This retrospective study aims to analyse the survivorship and functional outcomes of two samples with similar preoperative clinical and demographic data of lateral unicompartmental knee arthroplasty (UKA) performed with robotic and conventional surgery at a minimum 5-year follow-up.
In this retrospective study, the clinical records of two cohorts for 95 lateral UKA implants were analysed. The first cohort consisted of 43 patients with cemented lateral UKA performed with the conventional procedure (Conventional group). The second cohort consisted of 52 patients who received robot-assisted cemented lateral UKA (Robotic group). Clinical evaluation of the two samples entailed evaluating the Knee Injury and Osteoarthritis Outcome Score divided into subscales (symptoms and stiffness, pain, function in daily living, function in sport and recreation and quality of life) for each patient. Revision was defined as the failure of the implant (periprosthetic joint infection, periprosthetic fracture or aseptic loosening), and survival was based on implant revision.
The mean follow-up time was 90.3 ± 9.1 months for the Conventional Group and 95.4 ± 11.0 months for the Robotic Group (n.s.). Each patient was clinically evaluated on the day before surgery (T), at a minimum 1-year follow-up (T) and at a minimum 5-year follow-up (T). In both groups, all clinical scores improved between T and T and between T and T (p < 0.05); for both groups, no differences were noted in any clinical scores between T and T (n.s.). No significant differences in any clinical score were found between the two groups at each follow-up (n.s.). Survival analysis reported no differences between the two groups at the final 1-year follow-up, with three failures (2 aseptic loosening and 1 periprosthetic fracture) in the Conventional group and two failures (1 patellofemoral osteoarthritis and 1 inexplicable pain) in the Robotic group (n.s.).
This study shows excellent clinical outcomes and revision rates in robotic arm-assisted and manual techniques for lateral UKA, with no clinical differences at medium- to long-term follow-up.
Level III-comparative study.
本回顾性研究旨在分析两组接受机器人辅助与传统手术行外侧单髁膝关节置换术(UKA)患者的术后 5 年随访结果,两组患者术前临床和人口统计学数据相似。
本回顾性研究分析了 95 例外侧 UKA 植入物的两个队列的临床记录。第一组由 43 例接受传统方法固定外侧 UKA 的患者组成(传统组)。第二组由 52 例接受机器人辅助固定外侧 UKA 的患者组成(机器人组)。对这两个样本的临床评估包括评估每个患者的膝关节损伤和骨关节炎结果评分(Knee Injury and Osteoarthritis Outcome Score,KOOS),并分为子量表(症状和僵硬、疼痛、日常生活功能、运动和娱乐功能以及生活质量)。翻修为植入物失败(假体周围关节感染、假体周围骨折或无菌性松动),生存基于植入物翻修。
传统组的平均随访时间为 90.3±9.1 个月,机器人组为 95.4±11.0 个月(无统计学差异)。每位患者在手术前一天(T)、至少 1 年随访(T)和至少 5 年随访(T)时进行临床评估。在两组中,所有临床评分均在 T 与 T 之间和 T 与 T 之间均有改善(p<0.05);在 T 与 T 之间,两组的任何临床评分均无差异(无统计学差异)。在每个随访时间点,两组间任何临床评分均无显著差异(无统计学差异)。生存分析显示,在最终的 1 年随访时,两组间无差异,传统组有 3 例失败(2 例无菌性松动,1 例假体周围骨折),机器人组有 2 例失败(1 例髌股关节炎,1 例不明原因疼痛)(无统计学差异)。
本研究表明,在外侧 UKA 中,机器人辅助与手动技术均具有出色的临床结果和翻修率,在中至长期随访中无临床差异。
III 级-比较研究。