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机器人辅助全膝关节置换术(TKA)与患者满意度的增加无关:系统评价和荟萃分析。

Robotic assisted Total Knee Arthroplasty (TKA) is not associated with increased patient satisfaction: a systematic review and meta-analysis.

机构信息

International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD, USA.

Sina University Hospital, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Int Orthop. 2024 Jul;48(7):1771-1784. doi: 10.1007/s00264-024-06206-4. Epub 2024 May 6.

Abstract

PURPOSE

Total knee arthroplasty (TKA) is a common orthopedic surgery, yet postoperative dissatisfaction persists in around 20% of cases. Robotic total knee arthroplasty (rTKA) promises enhanced precision, but its impact on patient satisfaction compared to conventional TKA remains controversial (cTKA). This systematic review aims to evaluate patient satisfaction post-rTKA and compare outcomes with cTKA.

METHODS

Papers from the following databases were identified and reviewed: PubMed, Scopus, Web of Science, and the Cochrane Online Library, using keywords like "Knee replacement," "Total knee arthroplasty," "Robotic," and "Patient satisfaction." Extracted data included patient satisfaction measures, Knee Society Score, Oxford Knee Score, Forgotten Joint Score, SF-36, HSS, and KOOS. Statistical analysis, including odds ratio and 95% CI was performed using R software. Heterogeneity was assessed using Cochrane's Q test.

RESULTS

The systematic review included 17 articles, involving 1148 patients (571 in the rTKA group and 577 in the cTKA group) assessing patient satisfaction following rTKA. An analysis of proportions reveals rTKA satisfaction rate was 95%, while for cTKA, it was 91%. A meta-analysis comparing rTKA and cTKA found no statistically significant difference in patient satisfaction. Additionally, various patient-reported outcome measures (PROMs) were examined, showing mixed results across different studies and follow-up periods.

CONCLUSIONS

The results of this study found no difference in patient satisfaction outcomes in the short to mid-term for rTKA compared to conventional methods. This study does not assert superiority for the robotic approach, highlighting the need for careful consideration of various factors influencing outcomes in knee arthroplasty.

摘要

目的

全膝关节置换术(TKA)是一种常见的矫形外科手术,但术后仍有 20%左右的患者不满意。机器人全膝关节置换术(rTKA)承诺提高精度,但与传统 TKA 相比,其对患者满意度的影响仍存在争议(cTKA)。本系统评价旨在评估 rTKA 后患者的满意度,并比较其与 cTKA 的结果。

方法

使用“膝关节置换术”、“全膝关节置换术”、“机器人”和“患者满意度”等关键词,从以下数据库中确定和审查论文:PubMed、Scopus、Web of Science 和 Cochrane Online Library。提取的数据包括患者满意度衡量标准、膝关节协会评分、牛津膝关节评分、遗忘关节评分、SF-36、HSS 和 KOOS。使用 R 软件进行统计分析,包括比值比和 95%置信区间。使用 Cochrane's Q 检验评估异质性。

结果

系统评价包括 17 篇文章,涉及 1148 名患者(rTKA 组 571 名,cTKA 组 577 名),评估 rTKA 后患者的满意度。比例分析显示 rTKA 的满意度为 95%,而 cTKA 的满意度为 91%。比较 rTKA 和 cTKA 的荟萃分析发现,患者满意度无统计学差异。此外,还检查了各种患者报告的结果测量(PROMs),结果显示在不同的研究和随访期间存在混合结果。

结论

本研究发现,在短期至中期,rTKA 与传统方法相比,患者满意度结果无差异。本研究并未断言机器人方法具有优越性,突出了在膝关节置换术方面需要仔细考虑影响结果的各种因素。

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