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无图像引导机器人辅助全膝关节置换术治疗膝关节外翻畸形患者的疗效。

Outcomes of Image-Free Robotic Assisted Total Knee Arthroplasty in Patients Who Have Valgus Knee Deformities.

机构信息

Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, New York.

出版信息

J Arthroplasty. 2024 Sep;39(9S2):S235-S240. doi: 10.1016/j.arth.2024.03.032. Epub 2024 Mar 20.

Abstract

BACKGROUND

Valgus knee deformities pose a unique challenge in total knee arthroplasty (TKA) due to the complexity of achieving ligamentous balance and satisfactory alignment compared to varus or neutral deformities. Robotic-assisted (RA) TKA could aid in achieving improved component alignment and balance.

METHODS

We retrospectively evaluated a matched cohort of patients to compare image-free RA-TKA (n = 44) versus conventional manual (CM) TKA (n = 30) techniques in patients who have valgus deformity of 5 to 15 degrees, including radiographic and patient-reported outcomes measures (PROMs) over a 3-year period. The patient reported outcome measures (PROMs) studied to determine outcomes were: Western Ontario McMaster University Arthritis Index, Knee Society Score-Function Score, and Short Form 12-item Survey.

RESULTS

Overall, the RA-TKA cohort showed faster improvement in PROMs (37.16 ± 1 8.8 versus 25.74 ± 17.7, P = .02), shorter length of stay (1.41 versus 2.29 days, P = .02), and shorter operating room times (120.79 versus 123.67 minutes, P = .02) than CM-TK). Additionally, there was no difference in the use of primary versus varus-valgus constrained polyethylene liners between the cohorts.

CONCLUSIONS

In this investigation, RA-TKA yielded a slightly faster patient recovery, more objective measurements of ligamentous balance, and proved noninferior PROMs compared to CM-TKA for preoperative valgus knee deformities.

摘要

背景

与内翻或中立畸形相比,外翻膝关节畸形在全膝关节置换术(TKA)中带来了独特的挑战,因为实现韧带平衡和满意对线较为复杂。机器人辅助(RA)TKA 有助于获得更好的假体对线和平衡。

方法

我们回顾性评估了一组匹配的患者,比较了外翻 5 至 15 度的患者中无图像的 RA-TKA(n=44)与传统手动(CM)TKA(n=30)技术,研究了 3 年的影像学和患者报告的结果测量(PROMs)。为了确定结果,我们研究了患者报告的结果测量(PROMs):西部安大略省麦克马斯特大学关节炎指数、膝关节协会评分-功能评分和简短 12 项调查。

结果

总体而言,RA-TKA 组在 PROMs 方面的改善更快(37.16±18.8 与 25.74±17.7,P=0.02),住院时间更短(1.41 与 2.29 天,P=0.02),手术室时间更短(120.79 与 123.67 分钟,P=0.02),比 CM-TKA 短。此外,两组间在使用原发性与内翻-外翻约束聚乙烯衬垫方面无差异。

结论

在这项研究中,与 CM-TKA 相比,RA-TKA 使患者更快地恢复,对韧带平衡的客观测量更多,并且在术前外翻膝关节畸形方面证明了非劣效性的 PROMs。

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