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与传统器械相比,在执行术前数字计划时,机器人辅助全膝关节置换术在植入物位置和对线方面的准确性并未得到提高。

Robotic-assisted total knee arthroplasty is not associated with improved accuracy in implant position and alignment compared to conventional instrumentation in the execution of a preoperative digital plan.

作者信息

Nogalo Christian, Farinelli Luca, Meena Amit, di Maria Fabrizio, Abermann Elisabeth, Fink Christian

机构信息

Gelenkpunkt-Sports and Joint Surgery FIFA Medical Centre of Excellence Innsbruck Austria.

Research Unit for Orthopaedic Sports Medicine and Injury Prevention (OSMI) UMIT TIROL-Private University For Health Sciences and Health Technology Hall in Tirol Austria.

出版信息

J Exp Orthop. 2024 Apr 2;11(2):e12019. doi: 10.1002/jeo2.12019. eCollection 2024 Apr.

Abstract

PURPOSE

The primary objective of the present study was to evaluate if robotic-assisted total knee arthroplasty (RO-TKA) results in improved accuracy compared to conventional TKA (CO-TKA) with respect to alignment and component positioning executing a preoperative digital plan. The secondary objective was to compare patient-reported outcome measures (PROMs) between the two groups at 6 months of follow-up (FU).

METHODS

Patients who underwent primary TKA using the concept of constitutional alignment were identified from the database. Each patient underwent preoperative digital planning as well as postoperative evaluation of the preoperative plan (alignment and component position) using mediCAD® software (Hectec GmbH). Two groups were formed: (i) The RO-TKA group ( = 30) consisted of patients who underwent TKA with a robotic surgical system (ROSA®, Zimmer Biomet) and (ii) the CO-TKA group ( = 67) consisted of patients who underwent TKA with conventional instrumentation. To assess accuracy, all qualitative variables were analysed using the test. Tegner activity scale, Oxford Knee Score and visual analogue scale were assessed preop and at 6-month FU. To assess differences between the two groups, a 2 × 2 repeated measures analysis of variance was performed.

RESULTS

There was no significant ( > 0.05) difference in the accuracy of alignment as well as tibial and femoral component position between the two groups. At the 6-month FU, there was no significant ( > 0.05) difference in PROMs between the two groups.

CONCLUSION

While robotic TKA may have some potential advantages, no significant difference was found between robotic and conventional TKA with respect to limb alignment, clinical outcomes and component positioning.

LEVEL OF EVIDENCE

Level III.

摘要

目的

本研究的主要目的是评估与传统全膝关节置换术(CO-TKA)相比,机器人辅助全膝关节置换术(RO-TKA)在执行术前数字规划时,在对线和假体组件定位方面是否能提高准确性。次要目的是比较两组患者在随访6个月时的患者报告结局指标(PROMs)。

方法

从数据库中识别出采用体质对线概念进行初次全膝关节置换术的患者。每位患者均接受术前数字规划以及使用mediCAD®软件(Hectec GmbH)对术前规划(对线和假体组件位置)进行术后评估。形成两组:(i)RO-TKA组(n = 30)由使用机器人手术系统(ROSA®,捷迈邦美)进行全膝关节置换术的患者组成,(ii)CO-TKA组(n = 67)由使用传统器械进行全膝关节置换术的患者组成。为评估准确性,所有定性变量均使用检验进行分析。术前和随访6个月时评估Tegner活动量表、牛津膝关节评分和视觉模拟量表。为评估两组之间的差异,进行了2×2重复测量方差分析。

结果

两组在对线准确性以及胫骨和股骨假体组件位置方面无显著差异(P>0.05)。在随访6个月时,两组在患者报告结局指标方面无显著差异(P>0.05)。

结论

虽然机器人辅助全膝关节置换术可能有一些潜在优势,但在肢体对线、临床结局和假体组件定位方面,机器人辅助与传统全膝关节置换术之间未发现显著差异。

证据水平

III级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b083/10985632/5bd547fc3284/JEO2-11-e12019-g001.jpg

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