Functional and radiological outcomes of computer-assisted and handheld robotic total knee arthroplasty: A prospective randomised study

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee Pub Date : 2025-05-24 DOI:10.1016/j.knee.2025.05.003

Anoop Jhurani, Piyush Agarwal, Gaurav Ardawatia, Hardik Sahni, Mudit Srivastava

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引用次数: 0

Abstract

Background

Computer navigation (CAS) and robotic assisted surgery (RAS) have been shown to improve component alignment and decrease mechanical alignment outliers. However, the difference between soft tissue releases in both imageless technologies is not well known. The objective of this prospective randomised study was to compare the soft tissue releases, functional and radiological outcomes in TKA operated with CAS or RAS and find out the mean error between planned and achieved cuts with both technologies.

Methods

One-hundred patients were enrolled in each group after randomisation by computer-generated sequence: Group R, robotic assisted TKA; and Group C, CAS TKA. Functional and radiological outcomes were recorded preoperatively at 6 weeks, 3, 6, 12 and 24 months.

Results

Group R had significantly less soft tissue releases compared with Group C (P = 0.04). The robotic-assisted procedures achieved statistically higher accuracy for femoral distal femur cut thickness, femoral rotation, femoral flexion and femoral coronal angle (51%, 46%, 44%, 56%, respectively) in comparison with CAS TKA (44%, 25%, 29%, 46%, respectively). RAS achieved higher accuracy for tibial cut thickness, tibial slope, tibial cut coronal plane in comparison with CAS. Group R had significantly higher KOOS, HFKS and FJS-12 than Group C (P < 0.05) at the end of 2 years of follow up which, however, did not reach the minimal important clinical difference levels for each score.

Conclusion

The use of the handheld robotic system led to decreased soft tissue releases and mean cutting errors as compared with CAS, potentially leading to better pain scores and patient-reported outcomes.

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计算机辅助和手持机器人全膝关节置换术的功能和放射学结果：一项前瞻性随机研究

计算机导航（CAS）和机器人辅助手术（RAS）已被证明可以改善部件对齐并减少机械对齐异常值。然而，两种无成像技术中软组织释放的区别并不为人所知。这项前瞻性随机研究的目的是比较采用CAS或RAS进行TKA手术的软组织释放、功能和放射学结果，并找出两种技术计划和实现的切割之间的平均误差。方法采用计算机生成的随机序列，每组100例患者入组：R组，机器人辅助TKA；C组，CAS TKA。分别于术前6周、3、6、12和24个月记录功能和影像学结果。结果R组软组织释放量明显少于C组（P = 0.04）。与CAS TKA（分别为44%、25%、29%、46%）相比，机器人辅助手术在股骨远端切口厚度、股骨旋转、股骨屈曲和股骨冠状角方面的准确性更高（分别为51%、46%、44%、56%）。与CAS相比，RAS对胫骨切口厚度、胫骨斜度、胫骨切口冠状面具有更高的准确性。R组KOOS、HFKS和FJS-12显著高于C组(P <；0.05)，但未达到各评分的最小重要临床差异水平。结论与CAS相比，手持式机器人系统的使用减少了软组织释放和平均切割错误，可能导致更好的疼痛评分和患者报告的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.