Early Radiographic and Clinical Outcomes of Robotic-arm-assisted versus Conventional Total Knee Arthroplasty: A Multicenter Randomized Controlled Trial.

IF 1.8 2区 医学 Q2 ORTHOPEDICS
Orthopaedic Surgery Pub Date : 2024-11-01 Epub Date: 2024-08-12 DOI:10.1111/os.14196
Xiao Geng, Yuhang Zheng, Yang Li, Minwei Zhao, Yanqing Liu, Zijian Li, Hong Cai, Ming Zhang, Xinfeng Yan, Zhiwen Sun, Xin Lv, Feng Guo, Feng Li, Hua Tian
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引用次数: 0

Abstract

Objective: A robotic system was recently introduced to improve prosthetic alignment during total knee arthroplasty (TKA). The purpose of this multicenter, prospective, randomized controlled trial (RCT) was to determine whether robotic-arm-assisted TKA improves clinical and radiological outcomes when compared to conventional TKA.

Methods: One hundred and thirty patients who underwent primary TKA were enrolled in this prospective, randomized controlled trial, which was conducted at three hospitals. Five patients were lost to follow-up 6 weeks after surgery. Therefore, 125 participants (63 in the intervention group and 62 in the control group) remained in the final analysis. The primary outcome was the rate at which the mechanical axis of the femur deviated by less than 3° from the mechanical axis of the tibia. This was evaluated by full-length weight-bearing X-rays of the lower limb 6 weeks postoperatively. Secondary outcomes included operation times, 6-week postoperative functional outcomes evaluated by the American Knee Society score (KSS) and the Western Ontario and McMaster Universities osteoarthritis index (WOMAC), short form-36 (SF-36) health survey results, and the occurrence of adverse events (AEs) and serious adverse events (SAEs).

Results: At 6 weeks postoperatively, we found that the rate of radiographic inliers was significantly higher in the intervention group (78.7% vs 51.6%; p = 0.00; 95% confidence interval, 10.9% to 43.2%). The operation was significantly longer in the intervention group than in the control group (119.5 vs 85.0 min; p = 0.00). There were no significant differences in the 6-week postoperative functional outcomes, SF-36, AEs, and SAEs between the two groups. There were no AEs or SAEs that were determined to be "positively related" to the robotic system.

Conclusion: Robotic-arm-assisted TKA is safe and effective, as demonstrated in this trial.

Abstract Image

机器人手臂辅助与传统全膝关节置换术的早期放射学和临床结果:多中心随机对照试验。
目的:最近推出了一种机器人系统,用于改善全膝关节置换术(TKA)中的假体对位。这项多中心、前瞻性、随机对照试验(RCT)旨在确定与传统 TKA 相比,机械臂辅助 TKA 是否能改善临床和放射学结果:在三家医院进行的这项前瞻性随机对照试验共招募了 130 名接受初级 TKA 的患者。5名患者在术后6周失去了随访机会。因此,最终分析中保留了 125 名参与者(干预组 63 人,对照组 62 人)。主要结果是股骨机械轴与胫骨机械轴的偏差小于3°的比率。该指标通过术后 6 周的下肢全长负重 X 光片进行评估。次要结果包括手术时间、通过美国膝关节协会评分(KSS)和西安大略与麦克马斯特大学骨关节炎指数(WOMAC)评估的术后6周功能结果、短表-36(SF-36)健康调查结果,以及不良事件(AE)和严重不良事件(SAE)的发生情况:术后 6 周,我们发现干预组的放射学异常值发生率明显更高(78.7% vs 51.6%;P = 0.00;95% 置信区间,10.9% 至 43.2%)。干预组的手术时间明显长于对照组(119.5 分钟 vs 85.0 分钟;P = 0.00)。两组在术后 6 周的功能结果、SF-36、AEs 和 SAEs 方面无明显差异。没有发现与机器人系统 "正相关 "的AEs或SAEs:结论:本试验表明,机器人手臂辅助 TKA 是安全有效的。
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来源期刊
Orthopaedic Surgery
Orthopaedic Surgery ORTHOPEDICS-
CiteScore
3.40
自引率
14.30%
发文量
374
审稿时长
20 weeks
期刊介绍: Orthopaedic Surgery (OS) is the official journal of the Chinese Orthopaedic Association, focusing on all aspects of orthopaedic technique and surgery. The journal publishes peer-reviewed articles in the following categories: Original Articles, Clinical Articles, Review Articles, Guidelines, Editorials, Commentaries, Surgical Techniques, Case Reports and Meeting Reports.
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