Edward L Major, Harrison T Stone, James R Goetz, Ronald S Clarkson, Gregory S Hawk, Stephen T Duncan, Jeffrey B Selby
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引用次数: 0
Abstract
Background: Despite the increasing use of robotic-assisted total knee arthroplasty (r-TKA), data on functional outcomes remain limited. This study evaluated 6-week range of motion (ROM) outcomes in patients who underwent r-TKA vs conventional TKA (c-TKA) to determine whether robotic assistance improves early postoperative ROM.
Methods: A retrospective analysis was conducted on consecutive patients who underwent primary TKA by a single surgeon using r-TKA or c-TKA between 2019 and 2023. Exclusion criteria included simultaneous bilateral, revision, unicompartmental, and posttraumatic conversion arthroplasties. Knee flexion and extension ROM were measured preoperatively and at standardized 2- and 6-week postoperative visits. Manipulation under anesthesia (MUA) rates for postoperative stiffness were also analyzed. Linear mixed models assessed between-group differences in ROM over time, adjusting for race, sex, body mass index, and preoperative knee alignment.
Results: A total of 1124 patients (mean age 65.5 ± 8.7 years) were included, with 729 (64.9%) in the c-TKA cohort and 395 (35.1%) in the r-TKA cohort. Knee extension ROM between the c-TKA and r-TKA groups was not different preoperatively (1.3 ± 6.7 vs 0.8 ± 5.0; P = .209) or 6 weeks postoperatively (1.1 ± 3.6 vs 1.1 ± 2.9; P = .661). Knee flexion ROM between the c-TKA and r-TKA groups was not different preoperatively (114.7 ± 12.0 vs 115.3 ± 11.7; P = .677) or 6 weeks postoperatively (110.8 ± 12.6 vs 112.3 ± 11.6; P = .185). MUA rates were similar between the c-TKA and r-TKA cohorts (2.5% vs 3.0%; P = .359), respectively.
Conclusions: Robotic-assisted TKA demonstrated comparable early postoperative ROM and MUA rates to c-TKA. Future studies should explore long-term ROM outcomes and their correlation with patient-reported outcomes to further guide clinical practice.
背景:尽管机器人辅助全膝关节置换术(r-TKA)的使用越来越多,但关于功能结果的数据仍然有限。本研究评估了接受r-TKA与传统TKA (c-TKA)患者6周的活动范围(ROM)结果,以确定机器人辅助是否改善了术后早期的ROM。方法:回顾性分析了2019年至2023年间由一名外科医生使用r-TKA或c-TKA进行原发性TKA的连续患者。排除标准包括同时双侧、翻修、单室和创伤后转换性关节置换术。术前和术后标准化2周和6周随访时测量膝关节屈曲和伸直ROM。同时分析麻醉下操作(MUA)对术后僵硬的影响。线性混合模型评估各组间随时间的ROM差异,调整种族、性别、体重指数和术前膝关节对齐。结果:共纳入1124例患者(平均年龄65.5±8.7岁),其中c-TKA组729例(64.9%),r-TKA组395例(35.1%)。术前(1.3±6.7 vs 0.8±5.0;P = .209)和术后6周(1.1±3.6 vs 1.1±2.9;P = .661), c-TKA组和r-TKA组膝关节伸展ROM无差异。术前(114.7±12.0 vs 115.3±11.7;P = 0.677)和术后6周(110.8±12.6 vs 112.3±11.6;P = 0.185), c-TKA组和r-TKA组膝关节屈曲ROM无差异。c-TKA组和r-TKA组的MUA率相似(分别为2.5% vs 3.0%; P = 0.359)。结论:机器人辅助TKA显示出与c-TKA相当的术后早期ROM和MUA率。未来的研究应探讨长期ROM结果及其与患者报告结果的相关性,以进一步指导临床实践。证据等级:III,回顾性队列。
期刊介绍:
Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.