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机器人辅助技术不会影响肥胖和病态肥胖的全膝关节置换术患者的功能预后。

Robotic-assisted technology does not influence functional outcomes among obese and morbidly obese total knee arthroplasty patients.

作者信息

McCormick Brian P, Trent Sarah, Geng Xue, Lee Ji Won, Boucher Henry R

机构信息

Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, 3333 North Calvert Street, Suite 400, Baltimore, MD, 21218, USA.

Department of Orthopaedic Surgery, Donald and Barbara Zucker School of Medicine at Hofstra / Northwell, Great Neck, NY, USA.

出版信息

J Exp Orthop. 2023 Jul 31;10(1):76. doi: 10.1186/s40634-023-00634-8.

Abstract

PURPOSE

Despite benefits of total knee arthroplasty (TKA) on function and quality of life, obese patients have less improved functional outcomes following TKA compared to their normal weight counterparts. Furthermore, obesity is a risk factor for aseptic loosening and revision surgery following TKA. With known benefits of robotic-assisted TKA (RaTKA) in precision and patient satisfaction, we aimed to evaluate the differences in patient reported outcome and early complication rates for patients undergoing RaTKA versus conventional TKA among patients of varying BMI groups.

METHODS

This study was a retrospective cohort study of patients who underwent conventional versus RaTKA. Patients were grouped by BMI range (< 30 kg/m2, 30-40 kg/m2, and > 40 kg/m2). Patient-reported outcomes were measured by Oxford Knee Scores and 12-Item Short Form Survey scores preoperatively, 6-month, 1-year, and 2-year postoperatively. Mixed-effects linear models were built for each patient-reported outcome to assess the interaction between type of surgery and BMI while adjusting for known confounders such as demographic variables.

RESULTS

A total of 350 patients (n = 186 RaTKA, n = 164 conventional TKA) met inclusion criteria. SF-12 physical scores were significantly higher at 2-year follow-up among non-obese patients compared to obese and morbidly obese patients (p = 0.047). There was no statistically significant interaction between the type of surgery performed (RaTKA versus conventional TKA) and obesity regarding their effects on patient reported outcomes.

CONCLUSIONS

This study demonstrates no differences in functional outcomes among patients undergoing RaTKA compared to conventional TKA. Furthermore, obesity had no significant effect on this association.

LEVEL OF EVIDENCE

III.

摘要

目的

尽管全膝关节置换术(TKA)对功能和生活质量有益,但与正常体重的患者相比,肥胖患者在TKA术后功能改善效果较差。此外,肥胖是TKA术后无菌性松动和翻修手术的危险因素。鉴于机器人辅助TKA(RaTKA)在精度和患者满意度方面具有已知的优势,我们旨在评估不同BMI组患者接受RaTKA与传统TKA术后患者报告的结局及早期并发症发生率的差异。

方法

本研究是一项对接受传统TKA与RaTKA患者的回顾性队列研究。患者按BMI范围分组(<30kg/m²、30 - 40kg/m²和>40kg/m²)。通过牛津膝关节评分和术前、术后6个月、1年及2年的12项简短问卷调查评分来衡量患者报告的结局。针对每个患者报告的结局建立混合效应线性模型,以评估手术类型和BMI之间的相互作用,同时对人口统计学变量等已知混杂因素进行调整。

结果

共有350例患者(n = 186例RaTKA,n = 164例传统TKA)符合纳入标准。与肥胖和病态肥胖患者相比,非肥胖患者在2年随访时的SF - 12身体评分显著更高(p = 0.047)。所进行的手术类型(RaTKA与传统TKA)与肥胖对患者报告结局的影响之间无统计学显著的相互作用。

结论

本研究表明,与传统TKA相比,接受RaTKA的患者在功能结局方面无差异。此外,肥胖对这种关联无显著影响。

证据级别

III级。

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