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与导航引导技术相比,机器人辅助全膝关节置换术可降低术后并发症和缩短住院时间,且成本不会增加:一项全国性分析。

Robotic-assisted total knee arthroplasty reduces postoperative complications and length of stay without increased cost compared to navigation-guided techniques: A national analysis.

作者信息

Maman David, Laver Lior, Becker Roland, Mahamid Assil, Berkovich Yaron

机构信息

Department of Orthopedics, Carmel Medical Center, Haifa, Israel.

Rappaport Faculty of Medicine, Technion University Hospital (Israel Institute of Technology), Haifa, Israel.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2025 Jan;33(1):336-342. doi: 10.1002/ksa.12348. Epub 2024 Jul 2.

Abstract

INTRODUCTION

This study compares postoperative outcomes of robotic-assisted total knee arthroplasty (RA-TKA) versus navigation-guided total knee arthroplasty (NG-TKA). Using Nationwide Inpatient Sample (NIS) data, it provides an analysis of postoperative complications, mortality, hospital costs and duration of stay.

METHODS

The study analysed 217,715 patients (81,830 RA-TKA; 135,885 NG-TKA) using NIS data from 2016 to 2019. Elective TKA patients were identified through the International Classification of Diseases, 10th Revision codes. Statistical analyses, including logistic regression modelling, were performed using Statistical Package for the Social Sciences and MATLAB.

RESULTS

RA-TKA patients were younger (66.1 vs. 67.1 years, p < 0.0001) and had similar mortality rates (0.024% vs. 0.018%, p = 0.342) but shorter length of stay (LOS) (1.89 vs. 2.1 days, p < 0.0001). Mean total charges were comparable between RA-TKA ($66,180) and NG-TKA ($66,251, p = 0.669). RA-TKA demonstrated lower incidences of blood-related complications (11.67% vs. 14.19%, p < 0.0001), pulmonary oedema (0.0306% vs. 0.066%, p < 0.0001), deep vein thrombosis (0.196% vs. 0.254%, p = 0.006) and acute kidney injury (AKI) (1.356% vs. 1.483%, p = 0.016).

CONCLUSION

RA-TKA reduces postoperative complications and LOS without increasing costs, highlighting the relevance of this technology in patient care.

LEVEL OF EVIDENCE

Level III.

摘要

引言

本研究比较了机器人辅助全膝关节置换术(RA-TKA)与导航引导全膝关节置换术(NG-TKA)的术后结果。利用全国住院患者样本(NIS)数据,对术后并发症、死亡率、住院费用和住院时间进行了分析。

方法

该研究使用2016年至2019年的NIS数据,分析了217,715例患者(81,830例RA-TKA;135,885例NG-TKA)。通过国际疾病分类第十版代码识别择期全膝关节置换术患者。使用社会科学统计软件包和MATLAB进行统计分析,包括逻辑回归建模。

结果

RA-TKA患者更年轻(66.1岁对67.1岁,p < 0.0001),死亡率相似(0.024%对0.018%,p = 0.342),但住院时间更短(1.89天对2.1天,p < 0.0001)。RA-TKA(66,180美元)和NG-TKA(66,251美元,p = 0.669)的平均总费用相当。RA-TKA的血液相关并发症(11.67%对14.19%,p < 0.0001)、肺水肿(0.0306%对0.066%,p < 0.0001)、深静脉血栓形成(0.196%对0.254%,p = 0.006)和急性肾损伤(AKI)(1.356%对1.483%,p = 0.016)的发生率较低。

结论

RA-TKA可减少术后并发症和住院时间,且不增加费用,突出了该技术在患者护理中的相关性。

证据水平

三级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7931/11716347/885ae8b3b82c/KSA-33-336-g001.jpg

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