Center for Joint Disease, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea.
Clin Orthop Surg. 2023 Feb;15(1):82-91. doi: 10.4055/cios21138. Epub 2022 Apr 26.
Computer-assisted surgery, including robotic and navigational total knee arthroplasty (TKA), has been proposed as a technique used to improve alignment of implants. The purpose of this study was to compare the clinical and radiological outcomes during a minimum follow-up period of 10 years among robotic, navigational, and conventional TKA.
A total of 855 knees (robotic group, 194; conventional group, 270; and navigational group, 391) were available for physical and radiological examinations over a mean follow-up period of 10 years. The survival rate was analyzed using the Kaplan-Meier method based on the survival endpoint. The Hospital for Special Surgery score, Western Ontario and McMaster Universities Osteoarthritis Index, Knee Society Score, and range of motion were used for clinical evaluation. The hip-knee-ankle (HKA) axis angle, the coronal inclination of femoral and tibial components, and the presence of radiolucent lines were also assessed at the final follow-up.
All clinical assessments at the final follow-up revealed improvements in the three groups without any significant difference among the groups ( > 0.05). The cumulative 10-year survival rate was 97.4% in the robotic group, 96.6% in the conventional group, and 98.2% in the navigational group, with no significant difference ( = 0.447). The rates of complication-associated surgery were not significantly different among the groups ( = 0.907). Only the proportion of outliers in the HKA axis angle showed a significant difference ( = 0.001), but other radiological outcomes were not significantly different among the three groups.
Our study demonstrated satisfactory survival rates for robotic, navigational, and conventional TKAs and similar clinical outcomes during the long-term follow-up. Larger studies with continuous serial data are needed to confirm these findings.
计算机辅助手术，包括机器人和导航全膝关节置换术（TKA），已被提议作为一种用于改善植入物对线的技术。本研究的目的是比较机器人、导航和常规 TKA 在至少 10 年的随访期间的临床和影像学结果。
共有 855 例膝关节（机器人组 194 例，常规组 270 例，导航组 391 例）在平均 10 年的随访期间接受了体格检查和影像学检查。使用基于生存终点的 Kaplan-Meier 方法分析生存率。使用 HSS 评分、WOMAC 指数、膝关节协会评分和活动范围评估临床评估。还在最后一次随访时评估髋膝踝（HKA）轴角度、股骨和胫骨组件的冠状倾斜度以及是否存在透亮线。
三组在最后一次随访时的所有临床评估均显示出改善，且组间无显著差异（>0.05）。机器人组、常规组和导航组的 10 年累积生存率分别为 97.4%、96.6%和 98.2%，无显著差异（=0.447）。组间并发症相关手术的发生率无显著差异（=0.907）。仅 HKA 轴角度的离群值比例存在显著差异（=0.001），但三组的其他影像学结果无显著差异。
我们的研究表明，机器人、导航和常规 TKA 的生存率令人满意，且在长期随访中具有相似的临床结果。需要更大的、具有连续系列数据的研究来证实这些发现。
