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机器人辅助与传统单髁膝关节置换手术:一项全面的系统评价与荟萃分析

Robotic Versus Conventional Unicompartmental Knee Surgery: A Comprehensive Systematic Review and Meta-Analysis.

作者信息

Ghazal Ahmed Hussein, Fozo Zien Alabdin, Matar Sajeda G, Kamal Ibrahim, Gamal Mohamed Hesham, Ragab Khaled M

机构信息

Orthopaedics, Northwick Park Hospital, London North West University Healthcare NHS Trust, Harrow, GBR.

Orthopaedics, Ysbyty Gwynedd Hospital, Bangor, GBR.

出版信息

Cureus. 2023 Oct 8;15(10):e46681. doi: 10.7759/cureus.46681. eCollection 2023 Oct.

Abstract

Robotic-assisted surgery is a computer-controlled technique that may improve the accuracy and outcomes of unicompartmental total knee arthroplasty (TKA), a partial knee replacement surgery. The purpose of a meta-analysis about robotic-assisted versus conventional surgery for unicompartmental TKA is to compare the effectiveness of these two methods based on the current evidence. Our meta-analysis can help inform clinical decisions and guidelines for surgeons and patients who are considering unicompartmental TKA as a treatment option. We searched four online databases for studies that compared the two methods until March 2023. We used RevMan software to combine the data from the studies. We calculated the mean difference (MD) and the 95% confidence interval (CI) for each outcome, which are statistical measures of the difference and the uncertainty between the two methods. We included 16 studies in our analysis. We found that robotic-assisted surgery had a better hip-knee-ankle angle, which is a measure of how well the knee is aligned, than conventional surgery (MD = 0.86, 95% CI = 0.16-1.56). We also found that robotic-assisted surgery had a better Oxford Knee score, which is a measure of how well the knee functions, than conventional surgery (MD = 3.03, 95% CI = 0.96-5.110). This study compared the results of conventional and robotic-assisted unicompartmental knee arthroplasty in 12 studies. We concluded that robotic-assisted surgery may have some benefits over conventional surgery in terms of alignment and function of the knee. However, we did not find any significant difference between the two methods in terms of other outcomes, such as pain, range of motion, health status, and joint awareness. Therefore, we suggest that more research is needed to confirm these results and evaluate the long-term effects and cost-effectiveness of robotic-assisted surgery.

摘要

机器人辅助手术是一种计算机控制技术,可能会提高单髁全膝关节置换术(TKA,一种部分膝关节置换手术)的准确性和治疗效果。关于机器人辅助与传统手术治疗单髁TKA的荟萃分析的目的是根据现有证据比较这两种方法的有效性。我们的荟萃分析可以为考虑将单髁TKA作为治疗选择的外科医生和患者的临床决策及指南提供参考。我们在四个在线数据库中搜索了比较这两种方法的研究,直至2023年3月。我们使用RevMan软件合并研究数据。我们计算了每个结果的平均差(MD)和95%置信区间(CI),它们是两种方法之间差异和不确定性的统计量度。我们的分析纳入了16项研究。我们发现,机器人辅助手术在髋-膝-踝角(一种衡量膝关节对线情况的指标)方面比传统手术更好(MD = 0.86,95% CI = 0.16 - 1.56)。我们还发现,机器人辅助手术在牛津膝关节评分(一种衡量膝关节功能的指标)方面比传统手术更好(MD = 3.03,95% CI = 0.96 - 5.110)。这项研究在12项研究中比较了传统和机器人辅助单髁膝关节置换术的结果。我们得出结论,机器人辅助手术在膝关节对线和功能方面可能比传统手术有一些优势。然而,我们在疼痛、活动范围、健康状况和关节感知等其他结果方面未发现两种方法之间存在任何显著差异。因此,我们建议需要更多研究来证实这些结果,并评估机器人辅助手术的长期效果和成本效益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/138a/10589056/4c4766e976ee/cureus-0015-00000046681-i01.jpg

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