Koutserimpas Christos, Favroul Clément, Batailler Cécile, Servien Elvire, Lustig Sébastien
Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon North University Hospital, 103 Grande Rue de la Croix-Rousse, 69004 Lyon, France.
Orthopaedics Surgery and Sports Medicine Department, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon North University Hospital, 103 Grande Rue de la Croix-Rousse, 69004 Lyon, France.
J ISAKOS. 2025 Feb;10:100317. doi: 10.1016/j.jisako.2024.100317. Epub 2024 Sep 7.
Limited data exists on complications associated with robotic image-based system in knee arthroplasty. This study aims to document complications in robotic arm-assisted knee arthroplasties and evaluate the system's safety by comparing two femoral pin insertion methods: bicortical diaphyseal with additional stab wounds, and unicortical metaphyseal placement through the main incision.
All patients undergoing primary knee arthroplasty with the image-based robotic system (Mako, Stryker, Mako Surgical Corp., Fort Lauderdale, FL, USA) from 1st March 2021 to 31st January 2024 with a minimum follow-up of 2 months were included. Demographics, system and non-system-related complications, as well as outcomes were recorded. Complications were categorized as either major (requiring a second surgical intervention) or minor.
A total of 970 consecutive cases (median age 69.3 years) were analyzed. The unicortical group comprised 651 cases, while the bicortical group 319. The incidence of non-system-related complications was 2.37%, with the most common being joint stiffness (10 cases; 1.03%), followed by lateral femoral condyle fracture (4; 0.41%). The overall incidence of system-specific complications was 1.03%. Pin-related femoral fractures occurred in 0.2% of cases, all postoperatively and in the unicortical group. There was no statistically significant difference between the femoral pin insertion-related complication rates among the two groups (0.3% in the unicortical, compared to 0% in the bicortical group; p-value = 0.3). Complications included tibia fracture (0.1%), delayed wound healing (0.2%), superficial wound infection (0.1%), tibia osteomyelitis (0.1%), and "exostosis" (0.2%). The major complications rate was 0.3% and minor 0.7%.
Minimal system-specific overall complications indicate that robotic arm-assisted surgery is safe. The bicortical diaphyseal femoral pin insertion method does not increase the complication rates compared to the unicortical metaphyseal method.
III.
关于膝关节置换术中基于机器人图像系统相关并发症的数据有限。本研究旨在记录机器人手臂辅助膝关节置换术的并发症，并通过比较两种股骨钉插入方法来评估该系统的安全性：双皮质骨干插入法并附加刺伤，以及通过主切口进行单皮质干骺端放置法。
纳入2021年3月1日至2024年1月31日期间使用基于图像的机器人系统（Mako，史赛克，美国佛罗里达州劳德代尔堡的Mako Surgical Corp.）进行初次膝关节置换术且随访至少2个月的所有患者。记录人口统计学资料、系统相关和非系统相关并发症以及结果。并发症分为主要（需要二次手术干预）或次要。
共分析了970例连续病例（中位年龄69.3岁）。单皮质组包括651例，双皮质组319例。非系统相关并发症的发生率为2.37%，最常见的是关节僵硬（10例；1.03%），其次是股骨外侧髁骨折（4例；0.41%）。系统特定并发症的总发生率为1.03%。与钉相关的股骨骨折发生在0.2%的病例中，均在术后且发生在单皮质组。两组之间股骨钉插入相关并发症发生率无统计学显著差异（单皮质组为0.3%，双皮质组为0%；p值 = 0.3）。并发症包括胫骨骨折（0.1%）、伤口愈合延迟（0.2%）、浅表伤口感染（0.1%）、胫骨骨髓炎（0.1%）和“外生骨疣”（0.2%）。主要并发症发生率为0.3%，次要并发症发生率为0.7%。
系统特定的总体并发症极少，表明机器人手臂辅助手术是安全的。与单皮质干骺端方法相比，双皮质骨干股骨钉插入方法不会增加并发症发生率。
III级。
