Ward Gavin H, Montalbano Michael J
St. George's University, Department of Anatomical Sciences, Grenada.
J Clin Orthop Trauma. 2023 Jun 10;41:102189. doi: 10.1016/j.jcot.2023.102189. eCollection 2023 Jun.
Knee osteoarthritis is the most common joint disease globally. As obesity and age rates continue to rise in the U.S., the demand for total knee arthroplasty (TKA) is expected to grow significantly by 2030. Advanced techniques such as robotic-assisted (RA-TKA) aim to address this growing concern and improve patient quality-of-life. Since utilization of RA-TKA increased from 2010 to 2018, it is important to compare RA-TKA to conventional TKA (C-TKA) performance. This study compares RA-TKA to C-TKA in patient-reported WOMAC scores and objective range of motion (ROM) scores in eligible short-term (one-year or less) and long-term (one-year to fifteen-years) postoperative follow-up studies.
A systematic review using the PubMed database was performed to identify articles including RA-TKA, CA-TKA, C-TKA, WOMAC scores, and ROM scores.
Between RA-TKA and C-TKA, weighted analysis found significant effects in short-term (15.45, 95% CI: 4.96-25.94) and long-term (2.62, 95% CI: 0.62-4.61) WOMAC scores.
As approximately 7-20% of C-TKA surgeries result in poor subjective outcomes, and with revision rates and the demand for TKA set to rise, our analysis suggests that patient quality-of-life and cost effectiveness may be significantly improved by RA-TKA over C-TKA.
膝关节骨关节炎是全球最常见的关节疾病。随着美国肥胖率和老龄化率持续上升，预计到2030年全膝关节置换术（TKA）的需求将大幅增长。机器人辅助（RA-TKA）等先进技术旨在解决这一日益增长的问题并提高患者生活质量。由于2010年至2018年RA-TKA的使用率有所增加，因此将RA-TKA与传统TKA（C-TKA）的性能进行比较很重要。本研究在符合条件的短期（一年或更短时间）和长期（一年至十五年）术后随访研究中，比较了RA-TKA与C-TKA在患者报告的WOMAC评分和客观活动范围（ROM）评分方面的差异。
使用PubMed数据库进行系统评价，以识别包括RA-TKA、CA-TKA、C-TKA、WOMAC评分和ROM评分的文章。
在RA-TKA和C-TKA之间，加权分析发现短期（15.45，95%CI：4.96-25.94）和长期（2.62，95%CI：0.62-4.61）WOMAC评分有显著影响。
由于约7-20%的C-TKA手术会导致主观结果不佳，且随着TKA的翻修率和需求上升，我们的分析表明，与C-TKA相比，RA-TKA可能会显著改善患者生活质量和成本效益。
