人工与机器人辅助单髁膝关节置换术后的疼痛和疼痛处理

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-07-09 DOI:10.1016/j.jor.2025.07.008

Felix C. Oettl , Aaron I. Weinblatt , Yu-Fen Chiu , Gwo-Chin Lee , Stephen Lyman , Brian Chalmers , Matthew Austin , Alejandro Gonzalez Della Valle

{"title":"人工与机器人辅助单髁膝关节置换术后的疼痛和疼痛处理","authors":"Felix C. Oettl , Aaron I. Weinblatt , Yu-Fen Chiu , Gwo-Chin Lee , Stephen Lyman , Brian Chalmers , Matthew Austin , Alejandro Gonzalez Della Valle","doi":"10.1016/j.jor.2025.07.008","DOIUrl":null,"url":null,"abstract":"<div><h3>Aims</h3><div>The adoption of robotic assistance for unicondylar knee arthroplasty (UKA) is increasing, driven by reports of improved implant positioning. However, its impact on short-term patient outcomes remains debated. This study aimed to compare postoperative pain, opioid consumption, and length of hospital stay between manual (maUKA) and robotic-assisted (raUKA) procedures in a large, real-world cohort.</div></div><div><h3>Materials and methods</h3><div>We retrospectively identified 1369 opioid-naïve patients undergoing medial, unilateral UKA at a single institution between 2019 and 2023 (417 manual, 952 robotic). We collected data on Numeric Pain Rating Scale (NRS) scores, opioid consumption in morphine milligram equivalents (MMEs), and length of hospital stay. Multivariable linear regression was used to compare outcomes while controlling for patient-level confounders.</div></div><div><h3>Results</h3><div>After multivariable adjustment, we found no statistically significant difference between the manual and robotic groups in length of hospital stay (p = 0.6206) or total 90-day opioid consumption. Patients in the raUKA group reported slightly higher pain scores at the first postoperative measurement (Estimate −0.7, p < 0.001); however, no significant differences were observed in average, minimum, or maximum in-hospital pain scores. There was no significant difference in total inpatient opioid consumption.</div></div><div><h3>Conclusion</h3><div>In this large single-institution analysis, robotic assistance was not associated with improvements in postoperative pain, opioid use, or length of hospital stay compared to the manual technique. These findings suggest that potential benefits of robotic UKA related to implant accuracy may not translate to improved short-term clinical outcomes, a crucial consideration in the context of technology acquisition and healthcare costs.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"67 ","pages":"Pages 267-272"},"PeriodicalIF":1.5000,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Pain and pain management following manual versus robotic assisted unicondylar knee arthroplasty\",\"authors\":\"Felix C. Oettl , Aaron I. Weinblatt , Yu-Fen Chiu , Gwo-Chin Lee , Stephen Lyman , Brian Chalmers , Matthew Austin , Alejandro Gonzalez Della Valle\",\"doi\":\"10.1016/j.jor.2025.07.008\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Aims</h3><div>The adoption of robotic assistance for unicondylar knee arthroplasty (UKA) is increasing, driven by reports of improved implant positioning. However, its impact on short-term patient outcomes remains debated. This study aimed to compare postoperative pain, opioid consumption, and length of hospital stay between manual (maUKA) and robotic-assisted (raUKA) procedures in a large, real-world cohort.</div></div><div><h3>Materials and methods</h3><div>We retrospectively identified 1369 opioid-naïve patients undergoing medial, unilateral UKA at a single institution between 2019 and 2023 (417 manual, 952 robotic). We collected data on Numeric Pain Rating Scale (NRS) scores, opioid consumption in morphine milligram equivalents (MMEs), and length of hospital stay. Multivariable linear regression was used to compare outcomes while controlling for patient-level confounders.</div></div><div><h3>Results</h3><div>After multivariable adjustment, we found no statistically significant difference between the manual and robotic groups in length of hospital stay (p = 0.6206) or total 90-day opioid consumption. Patients in the raUKA group reported slightly higher pain scores at the first postoperative measurement (Estimate −0.7, p < 0.001); however, no significant differences were observed in average, minimum, or maximum in-hospital pain scores. There was no significant difference in total inpatient opioid consumption.</div></div><div><h3>Conclusion</h3><div>In this large single-institution analysis, robotic assistance was not associated with improvements in postoperative pain, opioid use, or length of hospital stay compared to the manual technique. These findings suggest that potential benefits of robotic UKA related to implant accuracy may not translate to improved short-term clinical outcomes, a crucial consideration in the context of technology acquisition and healthcare costs.</div></div>\",\"PeriodicalId\":16633,\"journal\":{\"name\":\"Journal of orthopaedics\",\"volume\":\"67 \",\"pages\":\"Pages 267-272\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-07-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of orthopaedics\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0972978X25002661\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of orthopaedics","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0972978X25002661","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

摘要

目的：机器人辅助单髁膝关节置换术（UKA）的应用越来越多，这是由于对植入物定位的改进。然而，它对患者短期预后的影响仍存在争议。本研究旨在比较人工（maUKA）和机器人辅助（raUKA）手术的术后疼痛、阿片类药物消耗和住院时间。材料和方法我们回顾性地确定了1369例opioid-naïve患者在2019年至2023年期间在一家机构接受了内侧单侧UKA（417例手动，952例机器人）。我们收集了数值疼痛评定量表（NRS）评分、吗啡毫克当量（MMEs）阿片类药物消耗和住院时间的数据。在控制患者水平混杂因素的情况下，采用多变量线性回归来比较结果。结果经多变量调整后，人工组和机器人组在住院时间（p = 0.6206）和总90天阿片类药物消耗方面无统计学差异。术后第一次测量时，raUKA组患者的疼痛评分略高(估计为- 0.7,p <；0.001);然而，在平均、最低或最高住院疼痛评分上没有观察到显著差异。住院患者阿片类药物总消耗量无显著差异。结论：在这项大型单机构分析中，与手工技术相比，机器人辅助与术后疼痛、阿片类药物使用或住院时间的改善无关。这些发现表明，机器人UKA与植入物准确性相关的潜在好处可能不会转化为改善的短期临床结果，这是技术获取和医疗成本背景下的一个关键考虑因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Pain and pain management following manual versus robotic assisted unicondylar knee arthroplasty

Aims

The adoption of robotic assistance for unicondylar knee arthroplasty (UKA) is increasing, driven by reports of improved implant positioning. However, its impact on short-term patient outcomes remains debated. This study aimed to compare postoperative pain, opioid consumption, and length of hospital stay between manual (maUKA) and robotic-assisted (raUKA) procedures in a large, real-world cohort.

Materials and methods

We retrospectively identified 1369 opioid-naïve patients undergoing medial, unilateral UKA at a single institution between 2019 and 2023 (417 manual, 952 robotic). We collected data on Numeric Pain Rating Scale (NRS) scores, opioid consumption in morphine milligram equivalents (MMEs), and length of hospital stay. Multivariable linear regression was used to compare outcomes while controlling for patient-level confounders.

Results

After multivariable adjustment, we found no statistically significant difference between the manual and robotic groups in length of hospital stay (p = 0.6206) or total 90-day opioid consumption. Patients in the raUKA group reported slightly higher pain scores at the first postoperative measurement (Estimate −0.7, p < 0.001); however, no significant differences were observed in average, minimum, or maximum in-hospital pain scores. There was no significant difference in total inpatient opioid consumption.

Conclusion

In this large single-institution analysis, robotic assistance was not associated with improvements in postoperative pain, opioid use, or length of hospital stay compared to the manual technique. These findings suggest that potential benefits of robotic UKA related to implant accuracy may not translate to improved short-term clinical outcomes, a crucial consideration in the context of technology acquisition and healthcare costs.

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

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.