Postoperative anterior knee pain in robot assisted total knee arthroplasty: a propensity score matching analysis.

IF 0.8 Q4 SURGERY
Surgery in practice and science Pub Date : 2025-08-05 eCollection Date: 2025-09-01 DOI:10.1016/j.sipas.2025.100301
Jiajie Yan, Shuangshuang Deng, Qiuyan Chen, Ning Liu, Songwei Huan, Min Zheng, Jiamin Zhang, Yanyan Gao
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Abstract

Background and objective: Anterior knee pain (AKP) remains a prevalent complication following total knee arthroplasty (TKA), affecting 4-60 % of patients. While robot-assisted TKA (RA-TKA) has demonstrated superior precision in prosthesis alignment compared to conventional manual TKA in the medium- and long-term, its impact on postoperative AKP remains underexplored. This study aimed to evaluate the medium- and long-term effects of RA-TKA on AKP intensity, functional outcomes, and knee mobility compared to CM-TKA.

Methods: In this retrospective cohort study, obese patients undergoing primary TKA for Kellgren-Lawrence grade 4 osteoarthritis between 2020 and 2023 were included. Propensity score matching balanced preoperative confounders, yielding 88 matched pairs (RA-TKA vs. CM-TKA). Outcomes included AKP intensity (Numeric Rating Scale, NRS), Knee Society Score (KSS), and active knee flexion/extension measured at 3, 6, 9, and 12 months postoperatively.

Results: The RA-TKA group exhibited significantly lower AKP intensity at 3 months (17.5 ± 8.1 vs. 24.6 ± 10.7, p = 0.034), with no between-group differences thereafter. At 12 months, RA-TKA demonstrated superior KSS (41.5 ± 6.2 vs. 34.4 ± 5.6, p = 0.042), and knee flexion (110.3 ± 11.8° vs. 107.5 ± 12.5°, p = 0.044) and extension (3.6 ± 1.4° vs. 4.1 ± 1.5°, p = 0.020). AKP peaked at 3 months in both groups, with similar temporal trends postoperatively after surgery 6 months.

Conclusion: RA-TKA demonstrated better short-term improvement in both AKP and knee functional capacity compared to standard total knee arthroplasty, and the improvements of knee flexion and extension are significant advantages. Although RA-TKA showed comparable long-term outcomes in knee function and AKP risk assessment to conventional surgery, its clinical significance lies in the critical early postoperative period when over 80 % of AKP events occur within the first 3 months.

机器人辅助全膝关节置换术后膝关节前侧疼痛:倾向评分匹配分析。
背景和目的:膝关节前侧疼痛(AKP)仍然是全膝关节置换术(TKA)后常见的并发症,影响4- 60%的患者。虽然机器人辅助TKA (RA-TKA)在中期和长期的假体对齐方面比传统的手动TKA表现出更高的精度,但其对术后AKP的影响仍未得到充分研究。本研究旨在评估RA-TKA与CM-TKA相比对AKP强度、功能结局和膝关节活动度的中长期影响。方法:在这项回顾性队列研究中,纳入了2020年至2023年间因Kellgren-Lawrence 4级骨关节炎接受原发性TKA的肥胖患者。倾向评分匹配平衡术前混杂因素,产生88对匹配(RA-TKA vs. CM-TKA)。结果包括AKP强度(数值评定量表,NRS),膝关节社会评分(KSS),以及术后3、6、9和12个月的膝关节活动度。结果:RA-TKA组在3个月时AKP强度显著降低(17.5±8.1比24.6±10.7,p = 0.034),此后无组间差异。在12个月时,RA-TKA显示出更好的KSS(41.5±6.2比34.4±5.6,p = 0.042),膝关节屈曲(110.3±11.8°比107.5±12.5°,p = 0.044)和伸直(3.6±1.4°比4.1±1.5°,p = 0.020)。两组患者的AKP在3个月时达到峰值,术后6个月时的时间趋势相似。结论:RA-TKA与标准全膝关节置换术相比,在短期内均能更好地改善AKP和膝关节功能,且膝关节屈伸的改善具有显著优势。尽管RA-TKA在膝关节功能和AKP风险评估方面的长期结果与常规手术相当,但其临床意义在于术后早期的关键时期,超过80%的AKP事件发生在前3个月内。
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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CiteScore
0.80
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