计算机导航和机器人辅助全髋关节置换术的术后效果和趋势。

IF 1.3 4区 医学 Q3 ORTHOPEDICS
HIP International Pub Date : 2024-09-01 Epub Date: 2024-08-08 DOI:10.1177/11207000241264256
Amit S Piple, Jennifer C Wang, William Hill, Matthew S Chen, Brandon S Gettleman, Kevin C Liu, Nathanael D Heckmann, Alexander B Christ
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引用次数: 0

摘要

简介:随着技术辅助全髋关节置换术(THA)数量的增加,有必要对机器人辅助(RA)和计算机导航(CN)THA的疗效进行描述。本研究的目的是评估CN-THA和RA-THA与传统器械(CON)THA相比的疗效和阿片类药物用量:在 Premier 数据库中查询了 2015-2020 年间所有接受初级、择期 THA 的患者。患者分为 3 组:CN、RA 或 CON-THA。评估了每年的使用趋势。进行了单变量和多变量分析,以评估术后 90 天的并发症风险。结果显示,术后第0天和第1天(POD)的阿片类药物消耗量为吗啡毫克当量(MME):总计确定了 474,707 例选择性 THAs(95.7% 为 CON,2.1% 为 CN,2.2% 为 RA)。考虑混杂因素后,CN-THA 患者发生假体周围关节感染 (PJI) (aOR:0.55,p < 0.001)和脱位(aOR 0.45,p < 0.001),但输血风险增加(aOR 1.97,p < 0.001),但输液风险增加(aOR 1.20,p < 0.001)、假体破损(aOR 3.88,p < 0.001)和假体周围骨折(aOR 1.72,p < 0.001)。与CON-THA相比,CN-THA患者在POD1的阿片类药物消耗量较低,RA-THA患者在POD0和2的阿片类药物消耗量较低:讨论:与CON-THA相比,CN-THA降低了PJI和脱位率,但增加了输血率,而RA-THA降低了脱位率,但增加了输血率、假体并发症和假体周围骨折。技术辅助THA与术后阿片类药物用量较低有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Postoperative outcomes and trends in computer-navigated and robotic-assisted total hip arthroplasty.

Introduction: As the volume of technology-assisted total hip arthroplasty (THA) increases, there is a need to characterise the outcomes of robotic-assisted (RA) and computer-navigated (CN) THA. The goal of this study was to assess outcomes and opioid consumption following CN-THA and RA-THA compared to conventionally-instrumented (CON) THA.

Methods: The Premier Database was queried for all patients who underwent primary, elective THA from 2015-2020. Patients were divided into 3 groups: CN, RA, or CON-THA. Yearly usage trends were assessed. Univariate and multivariate analyses were performed to assess the 90-day risk of postoperative complications. Opioid consumption was reported in morphine milligram equivalents (MME) for postoperative days (POD) 0 and 1.

Results: Overall, 474,707 elective THAs were identified (95.7% CON, 2.1% CN, 2.2% RA. After accounting for confounders, CN-THA patients were at decreased risk for periprosthetic joint infection (PJI) (aOR: 0.55, p < 0.001) and dislocation (aOR 0.45, p < 0.001), but increased risk for blood transfusion (aOR 1.97, <0.001) compared to CON-THA. RA-THA patients were at decreased risk of dislocation (aOR:0.66, p < 0.001) but increased risk for transfusion (aOR 1.20, p < 0.001), prosthesis breakage (aOR 3.88, p < 0.001), and periprosthetic fracture (aOR 1.72, p < 0.001). Opioid consumption for CN-THA patients was lower on POD1 and lower for RA-THA patients POD0 and 2 compared to CON-THA.

Discussion: CN-THA was associated with reduced rates of PJI and dislocation, but increased rates of blood transfusion while RA-THA was associated with decreased rates of dislocation, but increased rates of blood transfusion, prosthesis complications, and periprosthetic fracture compared to CON-THA. Technology-assisted THA was associated with lower postoperative opioid consumption.

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来源期刊
HIP International
HIP International 医学-整形外科
CiteScore
4.20
自引率
0.00%
发文量
70
审稿时长
2 months
期刊介绍: HIP International is the official journal of the European Hip Society. It is the only international, peer-reviewed, bi-monthly journal dedicated to diseases of the hip. HIP International considers contributions relating to hip surgery, traumatology of the hip, prosthetic surgery, biomechanics, and basic sciences relating to the hip. HIP International invites reviews from leading specialists with the aim of informing its readers of current evidence-based best practice. The journal also publishes supplements containing proceedings of symposia, special meetings or articles of special educational merit. HIP International is divided into six independent sections led by editors of the highest scientific merit. These sections are: • Biomaterials • Biomechanics • Conservative Hip Surgery • Paediatrics • Primary and Revision Hip Arthroplasty • Traumatology
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