Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN 38104, USA.
Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN 38104, USA.
Orthop Clin North Am. 2023 Apr;54(2):153-159. doi: 10.1016/j.ocl.2022.11.001.
Robotic-assisted total knee arthroplasty (RA-TKA) has become more popular in the United States. With the significant trend towards performing TKA in outpatient and ambulatory surgery center (ASC) settings, this study was implemented to determine the safety and efficacy of RA-TKA in an ASC.
A retrospective review identified 172 outpatient TKAs (86 RA-TKAs and 86 TKAs) performed between January 2020 and January 2021. All surgeries were performed by the same surgeon at the same free-standing ASC. Patients were followed for at least 90 days after surgery; complications, reoperations, readmissions, operative time, and patient-reported outcomes were recorded.
In both groups, all patients were successfully discharged home from the ASC on the day of surgery. No differences were noted in overall complications, reoperations, hospital admissions, or delays in discharge. RA-TKA had slightly longer operative times (79 vs 75 min [p = 0.017]) and total length of stay at the ASC (468 vs 412 min [p < 0.0001]) than conventional TKA. No significant differences were noted in outcome scores at 2-, 6-, or 12-week follow-ups.
Our results showed that RA-TKA can be successfully implemented in an ASC, with similar outcomes compared with TKA using conventional instrumentation. Initial surgical times were increased secondary to the learning curve of implementing RA-TKA. Long-term follow-up is necessary to determine implant longevity and long-term outcomes.
A retrospective review identified 172 outpatient TKAs (86 RA-TKAs and 86 TKAs) performed between January 2020 and January 2021. All surgeries were performed by the same surgeon at the same free-standing ASC. Patients were followed for at least 90 days after surgery; complications, reoperations, readmissions, operative time, and patient-reported outcomes were recorded.
In both groups, all patients were successfully discharged home from the ASC on the day of surgery. No differences were noted in overall complications, reoperations, hospital admissions, or delays in discharge. RA-TKA had slightly longer operative times (79 vs 75 min [p = 0.017]) and total length of stay at the ASC (468 vs 412 min [p < 0.0001]) than conventional TKA. No significant differences were noted in outcome scores at 2-, 6-, or 12-week follow-ups.
Our results showed that RA-TKA can be successfully implemented in an ASC, with similar outcomes compared with TKA using conventional instrumentation. Initial surgical times were increased secondary to the learning curve of implementing RA-TKA. Long-term follow-up is necessary to determine implant longevity and long-term outcomes.
机器人辅助全膝关节置换术（RA-TKA）在美国越来越受欢迎。随着在门诊和日间手术中心（ASC）环境中进行 TKA 的显著趋势，本研究旨在确定 ASC 中 RA-TKA 的安全性和有效性。
回顾性分析确定了 2020 年 1 月至 2021 年 1 月期间进行的 172 例门诊 TKA（86 例 RA-TKA 和 86 例 TKA）。所有手术均由同一位外科医生在同一独立的 ASC 进行。患者在手术后至少随访 90 天；记录并发症、再次手术、再入院、手术时间和患者报告的结果。
两组患者均于手术当日成功从 ASC 出院回家。总体并发症、再次手术、住院或出院延迟方面无差异。RA-TKA 的手术时间（79 分钟比 75 分钟 [p=0.017]）和 ASC 总住院时间（468 分钟比 412 分钟 [p<0.0001]）略长于传统 TKA。2、6 和 12 周随访时，结果评分无显著差异。
我们的结果表明，RA-TKA 可以成功地在 ASC 中实施，与使用传统器械的 TKA 相比具有相似的结果。由于实施 RA-TKA 的学习曲线，初始手术时间增加。需要进行长期随访以确定植入物的使用寿命和长期结果。
