The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, UK.
School of Medicine, The Dudley Group NHS Foundation Trust, Keele University, Dudley, UK.
J Robot Surg. 2024 Oct 9;18(1):364. doi: 10.1007/s11701-024-02048-9.
The aim of this study is To compare robotic-assisted and conventional total knee arthroplasty (TKA) on both short- and long-term outcomes A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Cochrane, Scopus, and Web of Science databases were searched for relevant studies. The studies included were randomised controlled trials directly comparing robotic-assisted versus conventional TKA. The outcomes were pooled as mean difference (MD) or risk ratio (RR), with 95% confidence interval. RevMan software version 5.4 was used for performing the statistical analysis. Nine studies deemed eligible for inclusion. The data showed a significant favouring of robotic-assisted than the conventional TKA in mechanical alignment, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and femoral coronal plane outliers (MD = - 1.10, 95% CI [- 1.51, - 0.69], p < 0.00001), (MD = - 1.19, 95% CI [- 2.35, - 0.03], p = 0.04), and (RR = 0.49, 95% CI [0.30, 0.80], p = 0.004), respectively. On the other hand, conventional TKA was better in range of motion-flexion (long-term) than the robotic-assisted one (MD = - 3.02, 95% CI [- 3.68, - 2.37], p < 0.00001). There were no significant differences between them in knee society score-knee score, knee society score-function score, change in hospital for special surgery (HSS) knee rating scale, and change in range of motion-extension (MD = - 0.36, 95% CI [- 2.43, 1.70], p = 0.73), (MD = - 0.34, 95% CI [- 2.36, 1.68], p = 0.74), (MD = 0.78, 95% CI [- 0.84, 2.40], p = 0.34), and (MD = 0.16, 95% [- 1.32, 1.64], p = 0.83), respectively. Robotic-assisted TKA demonstrated better outcomes than conventional TKA in terms of mechanical alignment and WOMAC scores. However, the conventional TKA showed a better range of motion-flexion in the long term. More data are needed to assess long-term outcomes comprehensively.
本研究旨在比较机器人辅助与传统全膝关节置换术（TKA）在短期和长期结果方面的差异。按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行系统评价。检索 PubMed、Cochrane、Scopus 和 Web of Science 数据库以获取相关研究。纳入的研究为直接比较机器人辅助与传统 TKA 的随机对照试验。将结局指标合并为均数差（MD）或风险比（RR），并给出 95%置信区间。使用 RevMan 软件版本 5.4 进行统计分析。符合纳入标准的 9 项研究。数据显示，在机械对线、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）以及股骨冠状面外偏（MD=-1.10，95%CI[-1.51，-0.69]，p<0.00001）、（MD=-1.19，95%CI[-2.35，-0.03]，p=0.04）和（RR=0.49，95%CI[0.30，0.80]，p=0.004）方面，机器人辅助 TKA 优于传统 TKA。另一方面，传统 TKA 在膝关节活动度-屈曲（长期）方面优于机器人辅助 TKA（MD=-3.02，95%CI[-3.68，-2.37]，p<0.00001）。在膝关节学会评分-膝关节评分、膝关节学会评分-功能评分、改良的美国特种外科医院膝关节评分（HSS）变化以及膝关节活动度-伸展变化方面，两者之间没有显著差异（MD=-0.36，95%CI[-2.43，1.70]，p=0.73）、（MD=-0.34，95%CI[-2.36，1.68]，p=0.74）、（MD=0.78，95%CI[-0.84，2.40]，p=0.34）和（MD=0.16，95%[-1.32，1.64]，p=0.83）。机器人辅助 TKA 在机械对线和 WOMAC 评分方面优于传统 TKA，但在长期方面，传统 TKA 显示出更好的膝关节活动度-屈曲。需要更多数据来全面评估长期结果。
