Ho Jade P Y, Jagota Ishaan, Twiggs Joshua G, Liu David W H
Gold Coast Centre for Bone and Joint Surgery, Palm Beach, Queensland, Australia; Department of Orthopaedic Surgery, Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia.
Enovis ANZ, Sydney, Australia; 360 Med Care, Sydney, Australia; College of Science and Engineering, Flinders University, Adelaide, Australia.
J Arthroplasty. 2025 Apr;40(4):893-899. doi: 10.1016/j.arth.2024.09.026. Epub 2024 Sep 20.
Early clinical data are important in the appraisal of newly introduced robotic-assisted surgery (RAS) systems in total knee arthroplasty (TKA). However, there are few studies to date comparing 1-year clinical outcomes between RAS and computer-assisted navigation (CAS), the forerunner in reducing alignment outliers. The aim of this study was to determine if there was a difference between these two groups in early clinical outcomes, including functional outcome and patient-reported outcome measures (PROMs).
A total of 158 propensity score-matched patients who underwent primary TKA with either CAS or RAS were retrospectively analyzed. Perioperative outcomes (navigation time, length of stay, complications, readmissions, transfusions, and technical failure), as well as functional outcome measures (range of motion, sit to stand test, timed-up-and-go test, single-leg stance test, calf raises, and step count), and PROMs (Oxford Knee Score, Knee Injury and Osteoarthritis Outcome Score, 12-item Short Form Survey, Forgotten Joint Score-12, and satisfaction) were compared between those who underwent CAS and those who underwent RAS.
Navigation time was shorter in the RAS group compared to the CAS group (mean difference, 15.4 minutes; P < 0.001). There were 2 complications reported in the CAS group (one patellar clunk, one periprosthetic joint infection), but none in the RAS group. There were no other readmissions, transfusions, or technical failures in either group. Postoperatively, there were no clinical differences in function between groups. Clinically meaningful improvement in PROMs was observed in both groups, with no differences.
The use of RAS resulted in shorter navigation time compared to CAS in TKA. No other differences were observed in early clinical outcomes between patients who underwent RAS and CAS.
早期临床数据对于评估全膝关节置换术（TKA）中最新引入的机器人辅助手术（RAS）系统至关重要。然而，迄今为止，很少有研究比较RAS与计算机辅助导航（CAS，减少对线异常的先驱技术）之间的1年临床结局。本研究的目的是确定这两组在早期临床结局（包括功能结局和患者报告结局测量指标（PROMs））方面是否存在差异。
对158例接受CAS或RAS初次TKA的倾向评分匹配患者进行回顾性分析。比较了接受CAS和接受RAS患者的围手术期结局（导航时间、住院时间、并发症、再入院、输血和技术失败），以及功能结局测量指标（活动范围、坐立试验、计时起立行走试验、单腿站立试验、提踵试验和步数）和PROMs（牛津膝关节评分、膝关节损伤和骨关节炎结局评分、12项简明健康调查、遗忘关节评分-12和满意度）。
与CAS组相比，RAS组的导航时间更短（平均差异为15.4分钟；P<0.001）。CAS组报告了2例并发症（1例髌骨撞击声，1例假体周围关节感染），而RAS组无并发症。两组均无其他再入院、输血或技术失败情况。术后，两组之间在功能上无临床差异。两组在PROMs方面均观察到具有临床意义的改善，且无差异。
在TKA中，与CAS相比，使用RAS可缩短导航时间。接受RAS和CAS的患者在早期临床结局方面未观察到其他差异。
