Department of Orthopaedics and Traumatology, Hospital Ampang, Jalan Mewah Utara, Taman Pandan Mewah, 68000, Ampang, Selangor, Malaysia.
Clinical Research Centre, Sunway Medical Centre, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia.
J Robot Surg. 2024 Aug 6;18(1):309. doi: 10.1007/s11701-024-02059-6.
Despite total knee arthroplasty (TKA) being the gold standard for end-stage knee osteoarthritis, 20% of patients remain dissatisfied. Robotic-assisted arthroplasty promises unparalleled control of the accuracy of bone cuts, implant positioning, control of gap balance, and resultant hip-knee-ankle (HKA) axis. Patients underwent clinical and radiological assessments, including knee CT scans and patient-reported outcome measures (PROMs), preoperatively. Follow-up assessments were conducted at 2 weeks, 6 weeks, and 3 months post-operatively, with imaging repeated at 6 weeks. A total of 155 patients underwent robotic-assisted TKA and have completed 3 months of follow-up. Mean pre-operative HKA axis was 7.39 ± 5.52 degrees varus, improving to 1.34 ± 2.22 degrees varus post-operatively. Restoration of HKA axis was 0.76 ± 1.9 degrees from intra-operative planning (p < 0.0005). Implant placement accuracy in the coronal plane was 0.08 ± 1.36 degrees (p = 0.458) for the femoral component and 0.71 ± 1.3 degrees (p < 0.0005) for the tibial component. Rotational alignment mean deviation was 0.39 ± 1.49 degrees (p = 0.001). Most patients (98.1%) had ≤ 2 mm difference in extension-flexion gaps. PROM scores showed improvement and exceeded pre-operative scores by 6 weeks post-surgery. Robotic-assisted knee arthroplasty provides precise control over traditionally subjective factors, demonstrating excellent early post-operative outcomes.Level of evidence Prospective observational study-II.
尽管全膝关节置换术（TKA）是治疗晚期膝关节骨关节炎的金标准，但仍有 20%的患者不满意。机器人辅助关节置换术承诺对骨切精度、植入物定位、间隙平衡控制以及由此产生的髋膝踝（HKA）轴具有无与伦比的控制。患者在术前接受了临床和影像学评估，包括膝关节 CT 扫描和患者报告的结果测量（PROM）。术后 2 周、6 周和 3 个月进行随访评估，6 周时重复影像学检查。共有 155 例患者接受了机器人辅助 TKA，并完成了 3 个月的随访。术前 HKA 轴的平均角度为 7.39±5.52 度，术后改善至 1.34±2.22 度。与术中计划相比，HKA 轴的恢复度为 0.76±1.9 度（p<0.0005）。冠状面植入物放置精度股骨组件为 0.08±1.36 度（p=0.458），胫骨组件为 0.71±1.3 度（p<0.0005）。旋转对线平均偏差为 0.39±1.49 度（p=0.001）。大多数患者（98.1%）的伸展-屈曲间隙差值≤2mm。PROM 评分显示术后 6 周开始改善，超过术前评分。机器人辅助膝关节置换术对传统上的主观因素具有精确的控制，显示出极好的早期术后结果。证据水平前瞻性观察研究-II。
