Cozzarelli Nicholas F, Khan Irfan A, Imam Nareena, Klein Gregg R, Levine Harlan, Seidenstein Ari, Zaid Musa B, Lonner Jess H
Division of Adult Reconstruction, Rothman Orthopaedic Institute, Philadelphia, PA, USA.
Arthroplast Today. 2023 Sep 16;23:101216. doi: 10.1016/j.artd.2023.101216. eCollection 2023 Oct.
Noise has been reported to occur with relatively high frequency after conventional total knee arthroplasty (C-TKA), and this may impact the incidence of patient satisfaction and function. The purpose of this study was to compare the rate of patient-reported prosthetic noise generation after robotically-assisted TKA (RA-TKA) and C-TKA.
A retrospective study was conducted of unilateral primary RA-TKAs and C-TKAs performed between 2018 and 2021. Patients completed a survey consisting of 4 Likert scale questions related to prosthetic noise generation and Knee Injury and Osteoarthritis Score Joint Replacement and Forgotten Joint Score were assessed prospectively preoperatively and at a minimum of 1-year of clinical follow-up. Statistical analysis was done utilizing T-tests and chi-square tests, with statistical significance defined as a -value < .05.
One hundred sixty-two RA-TKAs and 320 C-TKAs with similar baseline characteristics and functions were included. There were no significant differences in hearing or feeling grinding, popping, clicking, or clunking (40.7% vs 38.1%; = .647) between groups. Most RA-TKAs and C-TKAs were not dissatisfied regarding noise generation (70.4% vs 73.1%; = .596). In both cohorts, patients who reported noise generation had lower average Forgotten Joint Scores (45.5 vs 66.1; < .001) and lower postoperative Knee Injury and Osteoarthritis Score Joint Replacement scores (72.0 vs 81.4; < .001) than those who did not experience noise generation.
While RA-TKA may facilitate soft tissue balancing, there were no differences in prosthetic noise generation between RA-TKA and C-TKA. However, those who experience implant-generated noise have lower functional outcome scores.
据报道,传统全膝关节置换术(C-TKA)后噪音出现的频率相对较高,这可能会影响患者满意度和功能的发生率。本研究的目的是比较机器人辅助全膝关节置换术(RA-TKA)和C-TKA后患者报告的假体噪音产生率。
对2018年至2021年间进行的单侧初次RA-TKA和C-TKA进行回顾性研究。患者完成了一项由4个李克特量表问题组成的调查,这些问题与假体噪音产生有关,并在术前和至少1年的临床随访中前瞻性地评估了膝关节损伤和骨关节炎评分关节置换和遗忘关节评分。使用T检验和卡方检验进行统计分析,统计学显著性定义为P值<0.05。
纳入了162例RA-TKA和320例C-TKA,它们具有相似的基线特征和功能。两组之间在听到或感觉到研磨、弹响、咔哒声或碰撞声方面没有显著差异(40.7%对38.1%;P = 0.647)。大多数RA-TKA和C-TKA对噪音产生并不不满意(70.4%对73.1%;P = 0.596)。在两个队列中,报告有噪音产生的患者的平均遗忘关节评分(45.5对66.1;P < 0.001)和术后膝关节损伤和骨关节炎评分关节置换评分(72.0对81.4;P < 0.001)均低于未经历噪音产生的患者。
虽然RA-TKA可能有助于软组织平衡,但RA-TKA和C-TKA之间在假体噪音产生方面没有差异。然而,经历植入物产生噪音的患者功能结局评分较低。