一项前瞻性研究:在机器人辅助全膝关节置换术与传统全膝关节置换术后8周,使用匹兹堡睡眠质量指数比较睡眠质量——一项单中心研究。
A prospective study comparing sleep quality using Pittsburgh Sleep Quality Index at 8 weeks after robotic-assisted versus conventional total knee arthroplasty: a single-center study.
作者信息
Londhe Sanjay Bhalchandra, Shah Ravi Vinod, Antao Nicholas, Londhe Ishan, Shah Anay R, Namjoshi Zara, Baranwal Govindkumar, Singh Dolly
机构信息
Departmentof Orthopaedics, Criticare Asia Hospital, Andheri East, Mumbai, Maharashtra, India.
Departmentof Orthopaedics, Holy Spirit Hospital, Andheri, Mumbai, Maharashtra, India.
出版信息
J Robot Surg. 2025 Apr 30;19(1):191. doi: 10.1007/s11701-025-02339-9.
Total knee arthroplasty (TKA) is crucial for alleviating pain and improving the quality of life in patients with end-stage knee arthritis. Postoperative sleep disturbances are common and can persist for months following the surgery, potentially hindering the overall rehabilitation process and the quality of life. Robotic-assisted TKA (RATKA) offers greater precision and less invasiveness than conventional TKA (CTKA), potentially improving postoperative sleep quality. This study aims to compare sleep quality in patients undergoing RATKA versus CTKA. This prospective study (January 2024-June 2024) included 68 patients undergoing unilateral TKA for end-stage osteoarthritis, randomized into RATKA [Cuvis Joint Robotic Assisted System] (n = 34) and CTKA (n = 34) groups. Both the procedures were performed under spinal anesthesia along with Adductor Canal Block. Patients with pre-existing psychiatric conditions, diagnosed sleep disorders, or insomnia medication use were excluded. Postoperatively, patients followed a standardized multimodal pain management protocol. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) at 8 weeks post-TKA. Statistical analysis included Student's t test, effect size calculation, and confidence intervals, with significance set at p < 0.05. The baseline and preoperative clinical characteristics were comparable between the groups. At 8 weeks, the RATKA group had a mean PSQI score of 5.68 ±0.71, significantly lower than the CTKA group's score of 6.25 ± 0.92 (p = 0.0057, Cohen's d = 0.68) indicating better sleep quality in the RATKA group. RATKA was associated with significantly better postoperative sleep quality than CTKA at 8 weeks, as indicated by lower PSQI scores. These findings provide preliminary evidence supporting the potential benefits of robotic-assisted techniques in improving sleep outcomes following TKA. RATKA was associated with significantly better postoperative sleep quality than CTKA, likely due to reduced pain, soft-tissue preservation, and optimized implant positioning. These findings suggest potential advantages of robotic-assisted techniques in TKA recovery. Future multicenter studies with larger, more diverse populations and longer follow-up are needed to validate these results.
全膝关节置换术(TKA)对于缓解终末期膝关节炎患者的疼痛和提高生活质量至关重要。术后睡眠障碍很常见,并且可能在手术后持续数月,这可能会阻碍整体康复进程和生活质量。与传统全膝关节置换术(CTKA)相比,机器人辅助全膝关节置换术(RATKA)具有更高的精度和更小的侵入性,有可能改善术后睡眠质量。本研究旨在比较接受RATKA与CTKA的患者的睡眠质量。这项前瞻性研究(2024年1月至2024年6月)纳入了68例因终末期骨关节炎接受单侧TKA的患者,随机分为RATKA组[Cuvis关节机器人辅助系统](n = 34)和CTKA组(n = 34)。两种手术均在脊髓麻醉联合收肌管阻滞下进行。排除有既往精神疾病、已诊断的睡眠障碍或使用失眠药物的患者。术后,患者遵循标准化的多模式疼痛管理方案。在TKA术后8周,使用匹兹堡睡眠质量指数(PSQI)评估睡眠质量。统计分析包括学生t检验、效应量计算和置信区间,显著性设定为p < 0.05。两组之间的基线和术前临床特征具有可比性。在8周时,RATKA组的平均PSQI评分为5.68±0.71,显著低于CTKA组的6.25±0.92(p = 0.0057,科恩d值 = 0.68),表明RATKA组睡眠质量更好。PSQI评分较低表明,与CTKA相比,RATKA在8周时术后睡眠质量明显更好。这些发现提供了初步证据,支持机器人辅助技术在改善TKA术后睡眠结果方面的潜在益处。与CTKA相比,RATKA术后睡眠质量明显更好,可能是由于疼痛减轻、软组织保留和植入物定位优化。这些发现表明了机器人辅助技术在TKA恢复中的潜在优势。未来需要进行更大规模、更多样化人群和更长随访时间的多中心研究来验证这些结果。