Kafelov Moussa, Batailler Cécile, Shatrov Jobe, Al-Jufaili Jihad, Farhat Jawhara, Servien Elvire, Lustig Sébastien
Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Lyon University Hospital, Hospices Civils de Lyon, 103 Grande Rue de La Croix Rousse, 69004, Lyon, France.
Univ Lyon, Claude Bernard Lyon 1 University, IFSTTAR, LBMC UMR_T9406, 69622, Lyon, France.
Knee Surg Sports Traumatol Arthrosc. 2023 Dec;31(12):5591-5602. doi: 10.1007/s00167-023-07609-3. Epub 2023 Oct 18.
Few comparative studies assessed the current concept of individualised alignment for total knee arthroplasty (TKA) and their outcomes at mid-term. This study aimed to evaluate the functional outcomes at 1 year of primary TKA performed with a functional positioning technique based on an image-based robotic-assisted system, compared to conventional TKA performed with a restricted kinematic alignment technique.
This retrospective comparative study included 100 primary TKAs performed with functional positioning principles using an image-based robotic-assisted system. A control group included 100 primary TKAs with the same posterior-stabilised implant as the robotic group but performed with manual instrumentation and restricted kinematic alignment technique. In the robotic group, the mean age was 69.2 years old ± 7.9; the mean body mass index was 29.7 kg/m ± 4.6. The demographic characteristics were similar between both groups. Kujala score, Forgotten Joint Score (FJS), Knee Society Score (KSS) knee and KSS function were collected 12 months postoperatively. Normally distributed continuous variables were compared using the Student t test. For non-normally distributed continuous variables, the Mann-Whitney test was used.
FJS was significantly higher in the robotic group (76.3 ± 13 vs. 68.6 ± 16.9 in the conventional group; p = 0.026). At a 1-year follow-up, there was no significant difference in the KSS knee and KSS function scores and the Kujala score between both groups. The mean KSS knee score was 90.8 ± 11.4 in the robotic group versus 89.4 ± 9.6 in the conventional group (p = 0.082). The mean KSS function score was 91.4 ± 12.3 versus 91.3 ± 12.6, respectively (p = 0.778).
Functional positioning principles using an image-based robotic-assisted system achieved a higher Forgotten Joint Score 1 year after TKA compared to restricted kinematic alignment. Personalised alignment and implant positioning are interesting paths to improve the functional outcomes after TKA.
III.
很少有比较研究评估全膝关节置换术（TKA）个体化对线的当前概念及其中期结果。本研究旨在评估基于图像的机器人辅助系统的功能定位技术进行的初次TKA术后1年的功能结果，并与采用受限运动学对线技术进行的传统TKA进行比较。
这项回顾性比较研究纳入了100例使用基于图像的机器人辅助系统按照功能定位原则进行的初次TKA。一个对照组包括100例初次TKA，使用与机器人组相同的后稳定型假体，但采用手动器械和受限运动学对线技术。机器人组的平均年龄为69.2岁±7.9岁；平均体重指数为29.7kg/m±4.6。两组的人口统计学特征相似。术后12个月收集Kujala评分、遗忘关节评分（FJS）、膝关节协会评分（KSS）中的膝关节评分和KSS功能评分。对正态分布的连续变量使用Student t检验进行比较。对于非正态分布的连续变量，使用Mann-Whitney检验。
机器人组的FJS显著更高（76.3±13，而传统组为68.6±16.9；p = 0.026）。在1年随访时，两组之间的KSS膝关节评分、KSS功能评分和Kujala评分没有显著差异。机器人组的平均KSS膝关节评分为90.8±11.4，而传统组为89.4±9.6（p = 0.082）。平均KSS功能评分分别为91.4±12.3和91.3±12.6（p = 0.778）。
与受限运动学对线相比，使用基于图像的机器人辅助系统的功能定位原则在TKA术后1年获得了更高的遗忘关节评分。个性化对线和假体定位是改善TKA术后功能结果的有趣途径。
III级。
Zotero 插件