{"title":"在十字韧带固定机器人辅助全膝关节置换术后，恢复4°以内的原生胫骨后斜度可获得更好的临床疗效。","authors":"Young Tak Cho, Ho Jung Jung, Joong Il Kim","doi":"10.1002/ksa.12649","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The impact of posterior tibial slope (PTS) on clinical outcomes after robot-assisted total knee arthroplasty (RTKA) with functional alignment (FA) remains unclear. This study aimed to evaluate the effect of PTS on clinical outcomes following RTKA with FA.</p><p><strong>Methods: </strong>A prospectively collected database was retrospectively reviewed for patients who underwent primary cruciate-retaining RTKA (CR-RTKA) with FA using the MAKO robotic system, with a minimum 1-year follow-up. Knees were categorized into two groups: the small change (SC) group (n = 47) with a small PTS change (<4°) and the large change (LC) group (n = 53) with a large PTS change (≥4°). PTS change was defined as differences between pre- and post-operative PTS values. At the 1-year follow-up, clinical outcomes including Knee Society Score (KSS), Western Ontario and McMaster University Index (WOMAC), Forgotten Joint Score-12 (FJS-12) and post-operative complications were compared between groups. A multiple linear regression analysis was conducted to identify independent factors influencing post-operative WOMAC scores.</p><p><strong>Results: </strong>The SC group demonstrated significantly better post-operative clinical outcomes than the LC group (KSS-functional score: 85.63 ± 13.00 vs. 77.08 ± 18.39, p = 0.026; WOMAC: 10.46 ± 5.36 vs. 16.98 ± 10.69, p < 0.001; FJS-12: 75.94 ± 21.96 vs. 61.37 ± 26.61, p = 0.019). In multivariate regression analysis, PTS change was identified as an independent factor correlated with the post-operative WOMAC score (β: 0.842, p = 0.001). No post-operative complications were observed in either group during the follow-up period.</p><p><strong>Conclusions: </strong>Restoring the native PTS within 4° leads to better clinical outcomes following CR-RTKA with FA without post-operative complications for up to 1 year. Therefore, efforts to restore the native PTS are critical for achieving optimal short-term clinical outcomes after CR-RTKA with FA.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Restoring native posterior tibial slope within 4° leads to better clinical outcomes after cruciate-retaining robot-assisted total knee arthroplasty with functional alignment.\",\"authors\":\"Young Tak Cho, Ho Jung Jung, Joong Il Kim\",\"doi\":\"10.1002/ksa.12649\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The impact of posterior tibial slope (PTS) on clinical outcomes after robot-assisted total knee arthroplasty (RTKA) with functional alignment (FA) remains unclear. This study aimed to evaluate the effect of PTS on clinical outcomes following RTKA with FA.</p><p><strong>Methods: </strong>A prospectively collected database was retrospectively reviewed for patients who underwent primary cruciate-retaining RTKA (CR-RTKA) with FA using the MAKO robotic system, with a minimum 1-year follow-up. Knees were categorized into two groups: the small change (SC) group (n = 47) with a small PTS change (<4°) and the large change (LC) group (n = 53) with a large PTS change (≥4°). PTS change was defined as differences between pre- and post-operative PTS values. At the 1-year follow-up, clinical outcomes including Knee Society Score (KSS), Western Ontario and McMaster University Index (WOMAC), Forgotten Joint Score-12 (FJS-12) and post-operative complications were compared between groups. A multiple linear regression analysis was conducted to identify independent factors influencing post-operative WOMAC scores.</p><p><strong>Results: </strong>The SC group demonstrated significantly better post-operative clinical outcomes than the LC group (KSS-functional score: 85.63 ± 13.00 vs. 77.08 ± 18.39, p = 0.026; WOMAC: 10.46 ± 5.36 vs. 16.98 ± 10.69, p < 0.001; FJS-12: 75.94 ± 21.96 vs. 61.37 ± 26.61, p = 0.019). In multivariate regression analysis, PTS change was identified as an independent factor correlated with the post-operative WOMAC score (β: 0.842, p = 0.001). No post-operative complications were observed in either group during the follow-up period.</p><p><strong>Conclusions: </strong>Restoring the native PTS within 4° leads to better clinical outcomes following CR-RTKA with FA without post-operative complications for up to 1 year. Therefore, efforts to restore the native PTS are critical for achieving optimal short-term clinical outcomes after CR-RTKA with FA.</p><p><strong>Level of evidence: </strong>Level III.</p>\",\"PeriodicalId\":17880,\"journal\":{\"name\":\"Knee Surgery, Sports Traumatology, Arthroscopy\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-03-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Knee Surgery, Sports Traumatology, Arthroscopy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/ksa.12649\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee Surgery, Sports Traumatology, Arthroscopy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ksa.12649","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
摘要
目的：胫骨后坡（PTS）对机器人辅助全膝关节置换术（RTKA）后功能对齐（FA）临床结果的影响尚不清楚。本研究旨在评估PTS对FA合并RTKA后临床结果的影响。方法：回顾性分析前瞻性收集的数据库，使用MAKO机器人系统对FA患者进行原发性十字架保留RTKA (CR-RTKA)，随访至少1年。将膝关节分为两组：PTS变化较小的SC组（n = 47）(结果：SC组术后临床结果明显优于LC组(kss -功能评分：85.63±13.00比77.08±18.39,p = 0.026；WOMAC: 10.46±5.36 vs. 16.98±10.69，p结论：CR-RTKA合并FA术后1年无术后并发症，4°内恢复原始PTS的临床效果更好。因此，在CR-RTKA合并FA后，努力恢复原始PTS对于获得最佳的短期临床结果至关重要。证据等级：三级。
Restoring native posterior tibial slope within 4° leads to better clinical outcomes after cruciate-retaining robot-assisted total knee arthroplasty with functional alignment.
Purpose: The impact of posterior tibial slope (PTS) on clinical outcomes after robot-assisted total knee arthroplasty (RTKA) with functional alignment (FA) remains unclear. This study aimed to evaluate the effect of PTS on clinical outcomes following RTKA with FA.
Methods: A prospectively collected database was retrospectively reviewed for patients who underwent primary cruciate-retaining RTKA (CR-RTKA) with FA using the MAKO robotic system, with a minimum 1-year follow-up. Knees were categorized into two groups: the small change (SC) group (n = 47) with a small PTS change (<4°) and the large change (LC) group (n = 53) with a large PTS change (≥4°). PTS change was defined as differences between pre- and post-operative PTS values. At the 1-year follow-up, clinical outcomes including Knee Society Score (KSS), Western Ontario and McMaster University Index (WOMAC), Forgotten Joint Score-12 (FJS-12) and post-operative complications were compared between groups. A multiple linear regression analysis was conducted to identify independent factors influencing post-operative WOMAC scores.
Results: The SC group demonstrated significantly better post-operative clinical outcomes than the LC group (KSS-functional score: 85.63 ± 13.00 vs. 77.08 ± 18.39, p = 0.026; WOMAC: 10.46 ± 5.36 vs. 16.98 ± 10.69, p < 0.001; FJS-12: 75.94 ± 21.96 vs. 61.37 ± 26.61, p = 0.019). In multivariate regression analysis, PTS change was identified as an independent factor correlated with the post-operative WOMAC score (β: 0.842, p = 0.001). No post-operative complications were observed in either group during the follow-up period.
Conclusions: Restoring the native PTS within 4° leads to better clinical outcomes following CR-RTKA with FA without post-operative complications for up to 1 year. Therefore, efforts to restore the native PTS are critical for achieving optimal short-term clinical outcomes after CR-RTKA with FA.
期刊介绍：
Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication.
The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance.
Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards.
Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
