Hay Philip C, Collins William, Sidhu Verinder S, Alexander Kate, Fritsch Brett A, Gupta Sanjeev, Horsley Mark, Boyle Richard, Franks Daniel, Harris Ian A, Guzman Maurice
Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
Department of Orthopaedic Surgery, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
ANZ J Surg. 2025 Jul-Aug;95(7-8):1560-1568. doi: 10.1111/ans.70241. Epub 2025 Jul 2.
Robotic assistance and computer navigation systems are increasingly being used for total knee arthroplasty (TKA) with demonstrated improvements in early functional outcomes relative to conventional instrumentation. Patients are commonly discharged to inpatient rehabilitation following TKA with substantial associated costs to health care providers. We aimed to directly compare rates of discharge to inpatient rehabilitation between robotic assisted and computer navigated TKA to investigate differences in early functional outcomes between these technologies.
A retrospective cohort study of patients with knee osteoarthritis undergoing computer navigated or robotic assisted primary TKA at a single institution between 01 January 2016 and 31 December 2023 was conducted. Propensity score matching was performed 1:1 with propensity scores estimated using logistic regression accounting for age, sex, body mass index, American Society of Anaesthesiologists classification, insurance status, and unilateral vs. bilateral procedure. Multivariable regression analyses were performed to evaluate differences in discharge to inpatient rehabilitation and hospital length of stay.
Data analyses included 1034 patients (517 matched pairs) who underwent robotic assisted, or computer navigated TKA procedures respectively. The odds of discharge to inpatient rehabilitation for robotic assisted compared to computer navigated TKA were not significantly different (odds ratio (OR) = 0.79, 95% CI 0.54-1.2, p = 0.22). A significant mean difference in acute hospital length of stay was observed (-0.42 days, 95% CI -0.73 to -0.11 days, p = 0.008) between robotic assisted compared to computer navigated TKA groups.
Robotic assisted TKA does not reduce the odds of discharge to inpatient rehabilitation but may result in significantly shorter acute hospital length of stay compared to computer navigated TKA.
机器人辅助和计算机导航系统越来越多地用于全膝关节置换术（TKA），与传统器械相比，早期功能结局有明显改善。TKA术后患者通常被送往住院康复机构，这给医疗服务提供者带来了巨大的相关成本。我们旨在直接比较机器人辅助TKA和计算机导航TKA的住院康复出院率，以研究这些技术在早期功能结局方面的差异。
对2016年1月1日至2023年12月31日期间在单一机构接受计算机导航或机器人辅助初次TKA的膝骨关节炎患者进行回顾性队列研究。采用倾向评分匹配法，按1:1进行匹配，倾向评分使用逻辑回归估计，考虑年龄、性别、体重指数、美国麻醉医师协会分级、保险状况以及单侧与双侧手术情况。进行多变量回归分析，以评估住院康复出院率和住院时间的差异。
数据分析包括分别接受机器人辅助或计算机导航TKA手术的1034例患者（517对匹配病例）。机器人辅助TKA与计算机导航TKA相比，住院康复出院的几率无显著差异（优势比（OR）=0.79，95%置信区间0.54-1.2，p=0.22）。机器人辅助TKA组与计算机导航TKA组相比，急性住院时间存在显著平均差异（-0.42天，95%置信区间-0.73至-0.11天，p=0.008）。
机器人辅助TKA并不能降低住院康复出院的几率，但与计算机导航TKA相比，可能会显著缩短急性住院时间。
