Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Department of Orthopaedic Surgery, Anshin Clinic, Kobe, Japan.
Int Orthop. 2023 Jun;47(6):1473-1480. doi: 10.1007/s00264-023-05737-6. Epub 2023 Mar 17.
This study aimed to examine the prosthetic orientations, limb alignment, intraoperative soft tissue balance, and early clinical outcomes associated with the use of the relatively new handheld robot technique compared to those associated with the use of the conventional alignment guide for bi-cruciate stabilized total knee arthroplasty (TKA).
This retrospective cohort study compared the prosthetic orientation and limb alignment of 35 patients who underwent TKA using robotic assistance (robot group) with those of patients who underwent TKA using a conventional alignment guide (control group). The coronal femoral component alignment (FCA), coronal tibial component alignment (TCA), and the hip-knee-ankle (HKA) angle were compared between groups. Intraoperative soft tissue balance, including the joint component gap and varus/valgus balance assessed by an offset-type tensor, were also compared between groups. One year postoperatively, the clinical outcomes, including the range of motion and 2011 Knee Society Score (KSS), were compared between groups.
The HKA angle and FCA were 0.1° varus and 0.1° varus, respectively, in the robot group and 1.3° varus and 1.3° varus, respectively, in the control group. The difference in the HKA angle and the FCA, but not the TCA, between groups was statistically significant (p < 0.05). The intraoperative soft tissue balance showed more stable joint component gaps and varus/valgus balances throughout the range of motion in the robot group than in the control group. Clinical outcomes of the robot group showed superior 2011 KSS subscales compared to those of the control group.
The accuracy of the implantations and stable soft tissue balance in the robot group were superior to those of the control group. The robot group also had superior patient-reported scores for early clinical outcomes.
本研究旨在比较使用新型手持机器人技术与传统对线导板辅助行双髁稳定型全膝关节置换术（TKA）的假体定位、下肢对线、术中软组织平衡和早期临床结果。
本回顾性队列研究比较了 35 例使用机器人辅助行 TKA 的患者（机器人组）和使用传统对线导板行 TKA 的患者（对照组）的假体定位和下肢对线。比较了两组的冠状股骨组件对线（FCA）、冠状胫骨组件对线（TCA）和髋膝踝角（HKA）。还比较了两组的术中软组织平衡，包括关节组件间隙和通过偏移式张量评估的内翻/外翻平衡。术后 1 年，比较了两组的临床结果，包括关节活动度和 2011 年膝关节学会评分（KSS）。
机器人组的 HKA 角和 FCA 分别为 0.1°内翻和 0.1°内翻，对照组分别为 1.3°内翻和 1.3°内翻。组间 HKA 角和 FCA 存在差异，但 TCA 无差异（p<0.05）。机器人组在整个运动范围内的关节组件间隙和内翻/外翻平衡更加稳定。机器人组的临床结果显示，2011 年 KSS 亚量表优于对照组。
机器人组的植入物准确性和稳定的软组织平衡优于对照组。机器人组的患者报告的早期临床结果评分也更高。
