与调整后的机械对位相比,机器人辅助全膝关节置换术(TKA)采用功能对位的短期功能效果更好。

IF 1.8 Q2 ORTHOPEDICS
SICOT-J Pub Date : 2024-01-01 Epub Date: 2024-01-18 DOI:10.1051/sicotj/2024002
Michaud Jeffrey, Philippe Marchand, Pascal Kouyoumdjian, Remy Coulomb
{"title":"与调整后的机械对位相比,机器人辅助全膝关节置换术(TKA)采用功能对位的短期功能效果更好。","authors":"Michaud Jeffrey, Philippe Marchand, Pascal Kouyoumdjian, Remy Coulomb","doi":"10.1051/sicotj/2024002","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Ligament balancing is essential to the functional outcome of total knee arthroplasty (TKA). The optimal method of alignment remains a controversial issue. The primary objective was to compare the clinical outcomes of TKA between functional and adjusted mechanical alignment techniques. The secondary objectives were to compare bone resection, robotic alignment, and radiological assessment.</p><p><strong>Materials and methods: </strong>This was a retrospective case-control series comparing TKA performed with functional alignment (FA) and adjusted mechanical alignment (aMA). Sixty-four FA subjects were matched with 64 aMA controls. These two groups were matched for age, gender, body mass index (BMI), surgeon, and type of frontal deformity. Both surgical procedures were performed using the MAKO<sup>®</sup> haptic robotic system. Functional scores (Forgotten Joint Score (FJS), Knee Society Score (KSS), and Oxford Knee Score (OKS)) were measured at the final postoperative follow-up. A radiographic evaluation was performed at the same time.</p><p><strong>Results: </strong>Mean FJS were respectively 63.4 ± 25.1 [0-100] and 51.2 ± 31.8 [0-100] in FA versus aMA group (p = 0.034). Mean OKS were respectively 40.8 ± 6.3 [21-48] and 34.9 ± 11.8 [3-48] in FA versus aMA group (p = 0.027). Mean KSS were respectively 184.9 ± 17.0 [126-200] and 175.6 ± 23.1 [102-200] in FA versus aMA group (p = 0.02). The main residual symptom was \"none\" for 73.0% versus 57.8%, \"instability\" for 6.4% versus 21.9%, \"Pain\" for 19.1% versus 12.5%, and \"effusion\" for 1.6% and 7.8% respectively for FA and aMA group (p = 0.016). There were 4 complications in the FA group versus 5 in the aMA group (p > 0.999). Mean postoperative hip-knee-ankle (HKA) robotic assessment were respectively 177.3° ± 2.0 [172-180] and 178.2° ± 2.0 [173-180] for FA and aMA group (p = 0.018). The median difference between HKA robotic and HKA radiological was -3.0° (IQR = 3.0; p < 0.001).</p><p><strong>Conclusion: </strong>With greater residual deformity and without release, functional alignment showed a statistically significantly better short-term clinical outcome than adjusted mechanical alignment. This difference may not be clinically significant.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":null,"pages":null},"PeriodicalIF":1.8000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10798231/pdf/","citationCount":"0","resultStr":"{\"title\":\"Short-term functional outcomes of robotic-assisted TKA are better with functional alignment compared to adjusted mechanical alignment.\",\"authors\":\"Michaud Jeffrey, Philippe Marchand, Pascal Kouyoumdjian, Remy Coulomb\",\"doi\":\"10.1051/sicotj/2024002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Ligament balancing is essential to the functional outcome of total knee arthroplasty (TKA). The optimal method of alignment remains a controversial issue. The primary objective was to compare the clinical outcomes of TKA between functional and adjusted mechanical alignment techniques. The secondary objectives were to compare bone resection, robotic alignment, and radiological assessment.</p><p><strong>Materials and methods: </strong>This was a retrospective case-control series comparing TKA performed with functional alignment (FA) and adjusted mechanical alignment (aMA). Sixty-four FA subjects were matched with 64 aMA controls. These two groups were matched for age, gender, body mass index (BMI), surgeon, and type of frontal deformity. Both surgical procedures were performed using the MAKO<sup>®</sup> haptic robotic system. Functional scores (Forgotten Joint Score (FJS), Knee Society Score (KSS), and Oxford Knee Score (OKS)) were measured at the final postoperative follow-up. A radiographic evaluation was performed at the same time.</p><p><strong>Results: </strong>Mean FJS were respectively 63.4 ± 25.1 [0-100] and 51.2 ± 31.8 [0-100] in FA versus aMA group (p = 0.034). Mean OKS were respectively 40.8 ± 6.3 [21-48] and 34.9 ± 11.8 [3-48] in FA versus aMA group (p = 0.027). Mean KSS were respectively 184.9 ± 17.0 [126-200] and 175.6 ± 23.1 [102-200] in FA versus aMA group (p = 0.02). The main residual symptom was \\\"none\\\" for 73.0% versus 57.8%, \\\"instability\\\" for 6.4% versus 21.9%, \\\"Pain\\\" for 19.1% versus 12.5%, and \\\"effusion\\\" for 1.6% and 7.8% respectively for FA and aMA group (p = 0.016). There were 4 complications in the FA group versus 5 in the aMA group (p > 0.999). Mean postoperative hip-knee-ankle (HKA) robotic assessment were respectively 177.3° ± 2.0 [172-180] and 178.2° ± 2.0 [173-180] for FA and aMA group (p = 0.018). The median difference between HKA robotic and HKA radiological was -3.0° (IQR = 3.0; p < 0.001).</p><p><strong>Conclusion: </strong>With greater residual deformity and without release, functional alignment showed a statistically significantly better short-term clinical outcome than adjusted mechanical alignment. This difference may not be clinically significant.</p>\",\"PeriodicalId\":46378,\"journal\":{\"name\":\"SICOT-J\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10798231/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"SICOT-J\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1051/sicotj/2024002\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/18 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"SICOT-J","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1051/sicotj/2024002","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/18 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0

摘要

简介:韧带平衡对全膝关节置换术(TKA)的功能效果至关重要。最佳的对位方法仍是一个有争议的问题。该研究的主要目的是比较功能性对位技术和调整机械对位技术的临床疗效。次要目标是比较骨切除、机器人对位和放射学评估:这是一项回顾性病例对照系列研究,比较了采用功能性对位(FA)和调整型机械对位(aMA)进行的 TKA。64例FA受试者与64例aMA对照组相匹配。两组患者的年龄、性别、体重指数(BMI)、外科医生和额部畸形类型均匹配。两种手术均使用 MAKO® 触觉机器人系统进行。术后最后随访时测量了功能评分(Forgotten关节评分(FJS)、膝关节社会评分(KSS)和牛津膝关节评分(OKS))。同时还进行了放射学评估:FA组与 aMA 组的平均 FJS 分别为 63.4 ± 25.1 [0-100] 和 51.2 ± 31.8 [0-100](p = 0.034)。FA 组与 aMA 组的平均 OKS 分别为 40.8 ± 6.3 [21-48] 和 34.9 ± 11.8 [3-48](p = 0.027)。FA 组与 aMA 组的平均 KSS 分别为 184.9 ± 17.0 [126-200] 和 175.6 ± 23.1 [102-200](p = 0.02)。FA 组和 aMA 组的主要残余症状分别为:"无 "占 73.0% 对 57.8%,"不稳定 "占 6.4% 对 21.9%,"疼痛 "占 19.1% 对 12.5%,"渗出 "占 1.6% 对 7.8%(p = 0.016)。FA 组有 4 例并发症,而 aMA 组有 5 例(P > 0.999)。FA组和aMA组术后髋-膝-踝(HKA)机器人评估的平均值分别为177.3° ± 2.0 [172-180]和178.2° ± 2.0 [173-180](p = 0.018)。HKA机器人和HKA放射学的中位数差异为-3.0°(IQR = 3.0;P 结论:HKA机器人和HKA放射学的中位数差异为-3.0°(IQR = 3.0;P在残余畸形较大且未松解的情况下,功能性对位的短期临床疗效在统计学上明显优于调整后的机械性对位。这一差异可能并不具有临床意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Short-term functional outcomes of robotic-assisted TKA are better with functional alignment compared to adjusted mechanical alignment.

Introduction: Ligament balancing is essential to the functional outcome of total knee arthroplasty (TKA). The optimal method of alignment remains a controversial issue. The primary objective was to compare the clinical outcomes of TKA between functional and adjusted mechanical alignment techniques. The secondary objectives were to compare bone resection, robotic alignment, and radiological assessment.

Materials and methods: This was a retrospective case-control series comparing TKA performed with functional alignment (FA) and adjusted mechanical alignment (aMA). Sixty-four FA subjects were matched with 64 aMA controls. These two groups were matched for age, gender, body mass index (BMI), surgeon, and type of frontal deformity. Both surgical procedures were performed using the MAKO® haptic robotic system. Functional scores (Forgotten Joint Score (FJS), Knee Society Score (KSS), and Oxford Knee Score (OKS)) were measured at the final postoperative follow-up. A radiographic evaluation was performed at the same time.

Results: Mean FJS were respectively 63.4 ± 25.1 [0-100] and 51.2 ± 31.8 [0-100] in FA versus aMA group (p = 0.034). Mean OKS were respectively 40.8 ± 6.3 [21-48] and 34.9 ± 11.8 [3-48] in FA versus aMA group (p = 0.027). Mean KSS were respectively 184.9 ± 17.0 [126-200] and 175.6 ± 23.1 [102-200] in FA versus aMA group (p = 0.02). The main residual symptom was "none" for 73.0% versus 57.8%, "instability" for 6.4% versus 21.9%, "Pain" for 19.1% versus 12.5%, and "effusion" for 1.6% and 7.8% respectively for FA and aMA group (p = 0.016). There were 4 complications in the FA group versus 5 in the aMA group (p > 0.999). Mean postoperative hip-knee-ankle (HKA) robotic assessment were respectively 177.3° ± 2.0 [172-180] and 178.2° ± 2.0 [173-180] for FA and aMA group (p = 0.018). The median difference between HKA robotic and HKA radiological was -3.0° (IQR = 3.0; p < 0.001).

Conclusion: With greater residual deformity and without release, functional alignment showed a statistically significantly better short-term clinical outcome than adjusted mechanical alignment. This difference may not be clinically significant.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
SICOT-J
SICOT-J ORTHOPEDICS-
CiteScore
3.20
自引率
12.50%
发文量
44
审稿时长
14 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信