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分析机器人特定手术时间和手术团队焦虑水平及其对机器人辅助 TKA 中对线的影响。

Analysis of robot-specific operative time and surgical team anxiety level and its effect on alignment during robot-assisted TKA.

机构信息

Criticare Asia Hospital, Andheri, Maharashtra, India.

Apollo Hospitals, Hyderabad, India.

出版信息

J Robot Surg. 2024 Feb 22;18(1):86. doi: 10.1007/s11701-024-01823-y.

Abstract

Adapting to robotic-assisted (RA) total knee arthroplasty (TKA) is hindered by the surgeon's fear of extra time. The main purpose of this study was to determine the robot's operative time, and the secondary goals were to assess the surgical team's anxiety, implant location and size, and limb alignment. From February to April 2022, 40 participants participated in prospective research. The study included primary Cuvis joint active RA-TKA patients for end-stage arthritis, but conversion of unicompartmental knee arthroplasty to TKA, and patients with prior knee surgery were excluded. The active RA-TKA surgical time included surgeon-dependent and surgeon-independent/active robot time. The surgeon's anxiety was measured using the state-trait anxiety inventory (STAI). The implant size/position and limb alignment were checked by post-operative weight-bearing lateral, anteroposterior, and full-length scanograms. Operative time specifically related to active RA-TKA was higher in the first 10 cases as against 10-20, 20-30 and 30-40 cases which was observed to lower from cohort 2. A similar trend was observed for the surgical team's anxiety levels which seem to lower from cohort 2 (case 10-20). Cumulative experience of active RA-TKA showed no effect on the precision of implant alignment/ size, limb alignment and complications. The study showed progressive improvement in the surgical anxiety scores and reduction in operating time indicating the proficiency gained by the surgical team. Further no learning curve was involved in achieving the implant positioning and sizing, limb alignment with the absence of complications.

摘要

机器人辅助(RA)全膝关节置换术(TKA)的适应受到外科医生对额外时间的恐惧的阻碍。本研究的主要目的是确定机器人的手术时间,次要目标是评估手术团队的焦虑、植入物的位置和大小以及肢体对线。2022 年 2 月至 4 月,40 名参与者参与了前瞻性研究。该研究包括原发性 Cuvis 关节主动 RA-TKA 患者的终末期关节炎,但不包括单髁膝关节置换术转换为 TKA 以及既往膝关节手术的患者。主动 RA-TKA 的手术时间包括依赖外科医生的时间和独立于外科医生/主动机器人的时间。使用状态-特质焦虑量表(STAI)测量外科医生的焦虑程度。通过术后负重侧位、前后位和全长扫描图检查植入物的大小/位置和肢体对线。与第 10-20、20-30 和 30-40 例相比,前 10 例主动 RA-TKA 的手术时间特定于主动 RA-TKA,观察到第 2 组的手术时间降低。手术团队的焦虑水平也出现了类似的趋势,似乎从第 2 组(第 10-20 例)开始降低。主动 RA-TKA 的累积经验对植入物对线/大小、肢体对线和并发症的精度没有影响。研究表明,手术焦虑评分逐渐改善,手术时间缩短,表明手术团队的熟练度提高。进一步表明,在实现植入物定位和尺寸、肢体对线且无并发症方面,没有学习曲线。

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