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膝关节置换中机器人辅助手术与传统手术的比较:手术部位伤口并发症及恢复结果的荟萃分析

Comparing robot-assisted and conventional surgery in knee replacement: A meta-analysis of surgical site wound complications and recovery outcomes.

作者信息

Liang Hu, Hao Yangquan, Yu Wenxing

机构信息

Osteonecrosis & Joint Reconstruction Divvision, Xi'an Hong Hui Hospital, Xi'an Jiaotong University, Xi'an 710054, Shaanxi Province, China.

Osteonecrosis & Joint Reconstruction Divvision, Xi'an Hong Hui Hospital, Xi'an Jiaotong University, Xi'an 710054, Shaanxi Province, China.

出版信息

Asian J Surg. 2024 Nov 15. doi: 10.1016/j.asjsur.2024.10.154.

Abstract

OBJECTIVE

This meta-analysis aims to assess the impact of robotic and open-cut forms on postoperative complications in knee replacement surgeries.

METHOD

A comprehensive and systematic search was conducted on four significant databases using keywords derived from 'robot,' 'robot-assisted knee replacement (TAKR),' 'osteoarthritis,' 'knee arthroplasty,' 'wound healing,' 'knee replacement,' and 'postoperation' from the earliest available records until March 2024. A total of 590 publications were explored, and 16 related randomized clinical trials (RCTs) were analyzed in depth to unveil the role of robots in knee replacement surgery. In this meta-review, different parameters were adopted to evaluate various aspects: operation duration was used to measure the time from the primary incision to the wound closure after the surgery; Knee Society Score (KSS) and Hip Knee Ankle Angle (HKA) were used to evaluate the recovery and imaging features of the knees.

RESULTS

Data suggests there was little difference between the two methods except that the operation duration was higher in the robot-assisted group than in the conventional ones.

CONCLUSIONS

In broad terms, this meta-analysis indicates that employing robotics does not decrease specific post-surgical complications, such as wound infections and painful feelings. However, this advanced medical technology of robots' application helps reduce blood loss and drainage compared to patients with conventional surgery. Consequently, utilizing a robotic approach for knee replacement surgeries may only provide moderate promotion for wound recovery after the surgery. This insight is valuable for surgeons when choosing the most appropriate operative approach.

摘要

目的

本荟萃分析旨在评估机器人手术和开放式手术对膝关节置换术后并发症的影响。

方法

使用从“机器人”、“机器人辅助膝关节置换(TAKR)”、“骨关节炎”、“膝关节置换术”、“伤口愈合”、“膝关节置换”和“术后”中提取的关键词,对四个重要数据库进行了全面系统的检索,检索时间从最早可用记录至2024年3月。共检索到590篇文献,对16项相关随机临床试验(RCT)进行了深入分析,以揭示机器人在膝关节置换手术中的作用。在本荟萃分析中,采用了不同参数来评估各个方面:手术时长用于衡量从初次切口到术后伤口闭合的时间;膝关节协会评分(KSS)和髋膝踝角(HKA)用于评估膝关节的恢复情况和影像学特征。

结果

数据表明,两种方法之间差异不大,只是机器人辅助组的手术时长高于传统组。

结论

总体而言,本荟萃分析表明,使用机器人技术并不会减少特定的术后并发症,如伤口感染和疼痛感受。然而,与传统手术患者相比,这种机器人应用的先进医疗技术有助于减少失血和引流。因此,在膝关节置换手术中采用机器人手术方法可能仅对术后伤口恢复有适度促进作用。这一见解对外科医生选择最合适的手术方法具有重要价值。

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