Bull Hosp Jt Dis (2013). 2023 Dec;81(4):273-278.
The use of intraoperative technology is increasing among orthopedic surgeons in the United States. However, there is continued debate as to whether intraoperative technologies provide clinical benefits in patients undergoing total knee arthroplasty (TKA). This study sought to determine whether the use of a novel intraoperative navigation technology produces equivalent or superior short-term outcomes compared to conventional technique.
Fifty-nine consecutive patients underwent primary TKA with a novel imageless intraoperative navigational technology between October 2019 and January 2020 at a single, urban, orthopedic specialty hospital. A 1:1 cohort propensity matching was performed with patients with similar demographics who underwent primary TKA without the use of technology. Demographics, clinical data, as well as preoperative and 3-month Knee Injury and Osteoarthritis Outcome Score, Joint Replacement (KOOS, JR) scores were collected. Demographic differences, clinical data, and mean KOOS, JR scores were assessed using chi-squared analysis for categorical variables and independent sample t-test for continuous variables.
Upon 1:1 cohort matching, patients in both the navigational cohorts and non-navigational cohorts were statistically similar demographically. Length of stay (2.11 vs. 1.71 days; p = 0.108), surgical time (108.89 vs. 101.19 minutes, p = 0.066), discharge disposition (p = 0.675), 90- day readmissions (4 vs. 4, p = 0.999), and 90-day reoperations (2 vs. 2, p = 0.999) did not statistically differ between the two matched cohorts. Additionally, KOOS, JR scores evaluated between the two cohorts preoperatively (46.06 vs. 45.17, p = 0.836) and at 3-month follow-up (57.63 vs. 55.06, p = 0.580) were similar.
This study demonstrates that the use of this novel intraoperative navigational technology yields similar short-term TKA results when compared to conventionally performed TKA. Further studies are required to validate new technologies and determine their effect on long-term clinical and patient-reported outcomes.
在美国，骨科医生越来越多地使用术中技术。然而，对于术中技术是否能为接受全膝关节置换术（TKA）的患者带来临床益处，仍存在持续的争论。本研究旨在确定使用新型术中导航技术是否与传统技术相比产生等效或更好的短期结果。
2019 年 10 月至 2020 年 1 月，在一家城市骨科专科医院，59 例连续患者接受了新型无图像术中导航技术的初次 TKA。通过与未使用技术的初次 TKA 患者进行 1:1 队列倾向匹配，对具有相似人口统计学特征的患者进行了匹配。收集人口统计学、临床数据以及术前和 3 个月膝关节损伤和骨关节炎结果评分（KOOS，JR）评分。使用卡方分析评估分类变量和独立样本 t 检验评估连续变量的人口统计学差异、临床数据和平均 KOOS，JR 评分。
经过 1:1 队列匹配，导航组和非导航组的患者在人口统计学上具有统计学上的相似性。住院时间（2.11 天与 1.71 天；p = 0.108）、手术时间（108.89 分钟与 101.19 分钟，p = 0.066）、出院处置（p = 0.675）、90 天再入院率（4 例与 4 例，p = 0.999）和 90 天再次手术率（2 例与 2 例，p = 0.999）在两组匹配队列之间无统计学差异。此外，两组患者术前（46.06 分与 45.17 分，p = 0.836）和 3 个月随访时（57.63 分与 55.06 分，p = 0.580）的 KOOS，JR 评分相似。
本研究表明，与传统 TKA 相比，使用这种新型术中导航技术可获得相似的短期 TKA 结果。需要进一步的研究来验证新技术并确定它们对长期临床和患者报告结果的影响。
