Ohio University Heritage College of Osteopathic Medicine, Athens, OH, USA.
OrthoNeuro, New Albany, OH, USA.
J Osteopath Med. 2023 Jul 28;124(1):21-25. doi: 10.1515/jom-2023-0087. eCollection 2024 Jan 1.
With the growing number of robotic knee arthroplasties being performed, new outcomes must be analyzed to provide a database for comparing robotic and nonrobotic surgeries. These results can be utilized in the future to properly assess the significance of utilizing robotic technology in the operating room regarding patient outcomes and cost.
The aims of this study are to: (1) analyze adverse outcomes from robotic-assisted knee arthroplasty and its relation to sex, body mass index (BMI), and age; and (2) explore any possible differences in outcomes among robotic-assisted unicompartmental knee arthroplasty (UKA) and robotic-assisted total knee arthroplasty (TKA). It is hypothesized that sex, BMI, and age will play a role in adverse events experienced among robotic-assisted knee arthroplasty. It is hypothesized that adverse outcomes will differ in robotic-assisted TKA v UKA.
A retrospective analysis was performed utilizing 1,300 patient cases from a single surgeon that underwent robotic-assisted UKA or TKA utilizing a robotic surgical system. Demographics were sorted by age, sex, and BMI. Outcomes were sorted by the type of adverse event. The most common adverse event was further statistically analyzed by age, sex, and BMI and then compared to the total cohort. The most common adverse event was also broken down by TKA vs. UKA.
The average age of the individuals undergoing this procedure was 63.6 years, with 52.3 % being female. The average BMI was 32.2. Of the 87 patients who experienced adverse events, 111 total events were documented. Manipulation under anesthesia (MUA) was the highest experienced adverse event. Among the MUA events, 79.5 % had a BMI over 30 (p=0.067), 72.8 % were female (p=0.014), and the average age was 59 years (p=0.019). Among the MUA adverse events, 76.9 % (n=30) were following a TKA and 23.1 % were following a UKA. When considering the entire sample (n=1,300), there was a statistically significant 12.6 times greater odds that an MUA occurred among those who had a TKA vs. UKA (p<0.001). Similar results were discovered when only considering those who had experienced an adverse event (n=87) because the odds of an MUA occurring among those who underwent a TKA was 4.67 times greater than those who underwent a UKA (p<0.001).
MUA was the most common adverse event in this cohort of robotic-assisted knee arthroplasties. The other adverse events did not yield large enough cohort sizes to analyze statistically in relation to specific patient demographics. Younger patients and females were at significantly greater odds of needing MUA. A BMI over 30 was not found to have a statistically significant risk of needing an MUA after robotic-assisted knee arthroplasty. Among the total cohort, those who underwent a TKA were at a 12.6 times greater odds of needing an MUA than those who received a UKA.
随着越来越多的机器人膝关节置换手术的开展，必须分析新的结果，为比较机器人手术和非机器人手术提供数据库。这些结果可用于未来在患者结果和成本方面正确评估手术室中使用机器人技术的重要性。
本研究的目的是：（1）分析机器人辅助膝关节置换术的不良结果及其与性别、体重指数（BMI）和年龄的关系；（2）探讨机器人辅助单髁膝关节置换术（UKA）和机器人辅助全膝关节置换术（TKA）之间结果的任何可能差异。假设性别、BMI 和年龄将在机器人辅助膝关节置换术的不良事件中发挥作用。假设机器人辅助 TKA 与 UKA 的不良结果会有所不同。
对一位外科医生使用机器人手术系统进行的 1300 例机器人辅助 UKA 或 TKA 患者的病例进行回顾性分析。按年龄、性别和 BMI 对人口统计学数据进行分类。按不良事件类型对结果进行分类。最常见的不良事件进一步按年龄、性别和 BMI 进行统计学分析，并与总队列进行比较。还按 TKA 与 UKA 对最常见的不良事件进行了细分。
接受该手术的个体的平均年龄为 63.6 岁，其中 52.3%为女性。平均 BMI 为 32.2。在 87 名出现不良事件的患者中，共记录了 111 项不良事件。全身麻醉下的手法复位（MUA）是发生率最高的不良事件。在 MUA 事件中，79.5%的 BMI 超过 30（p=0.067），72.8%为女性（p=0.014），平均年龄为 59 岁（p=0.019）。在 MUA 不良事件中，76.9%（n=30）是在 TKA 后发生的，23.1%是在 UKA 后发生的。当考虑整个样本（n=1300）时，MUA 在 TKA 患者中的发生几率比 UKA 患者高 12.6 倍（p<0.001）。当仅考虑发生不良事件的患者（n=87）时，也发现了类似的结果，因为 TKA 患者发生 MUA 的几率是 UKA 患者的 4.67 倍（p<0.001）。
在本机器人辅助膝关节置换队列中，MUA 是最常见的不良事件。其他不良事件没有产生足够大的队列规模，无法在特定患者人口统计学方面进行统计学分析。年轻患者和女性发生 MUA 的可能性显著增加。机器人辅助膝关节置换术后 BMI 超过 30 并不具有统计学上需要 MUA 的风险。在总队列中，接受 TKA 的患者发生 MUA 的几率是接受 UKA 的患者的 12.6 倍。
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