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Title: [Effect of robotic-arm assisted total knee arthroplasty on femoral rotation alignment and its short-term effectiveness].
Author: Sun M, Yang L, Guo L, He R.
Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2021 Jul 15; 35(7):807-812. PubMed ID: 34308585.
Abstract:
OBJECTIVE: To investigate the improvement of femoral rotation alignment in total knee arthroplasty (TKA) by robotic-arm assisted positioning and osteotomy and its short-term effectiveness. METHODS: Between June 2020 and November 2020, 60 patients (60 knees) with advanced osteoarthritis of the knee, who met the selection criteria, were selected as the study subjects. Patients were randomly divided into two groups according to the random number table method, with 30 patients in each group. Patients were treated with robotic-arm assisted TKA (RATKA) in trial group, and with conventional TKA in control group. There was no significant difference in gender, age, side and course of osteoarthritis, body mass index, and the preoperative hip-knee-ankle angle (HKA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), posterior condylar angle (PCA), knee society score-knee (KSS-K) and KSS-function (KSS-F) scores between the two groups ( P>0.05). The clinical (KSS-K, KSS-F scores) and imaging (HKA, LDFA, MPTA, PCA) evaluation indexes of the knee joints were compared between the two groups at 3 months after operation. RESULTS: All patients were successfully operated. The incisions in the two groups healed by first intention, with no complications related to the operation. Patients in the two groups were followed up 3-6 months, with an average of 3.9 months. KSS-K and KSS-F scores of the two groups at 3 months after operation were significantly higher than those before operation ( P<0.05), but there was no significant difference between the two groups ( P>0.05). X-ray re-examination showed that the prosthesis was in good position, and no prosthesis loosening or sinking occurred. HKA, MPTA, and PCA significantly improved in both groups at 3 months after operation ( P<0.05) except LDFA. There was no significant difference in HKA, LDFA, and MPTA between the two groups ( P>0.05). PCA in trial group was significantly smaller than that in control group ( t=2.635， P=0.010). CONCLUSION: RATKA can not only correct knee deformity, relieve pain, improve the quality of life, but also achieve the goal of restoring accurate femoral rotation alignment. There was no adverse event after short-term follow-up and the effectiveness was satisfactory. 目的: 探讨人工全膝关节置换术（total knee arthroplasty，TKA）中使用手术机器人辅助定位及截骨后，股骨旋转对线改善情况及早期疗效。. 方法: 选择 2020 年 6 月—11 月 60 例（60 膝）符合选择标准的终末期膝骨关节炎患者作为研究对象，按照随机数字表法分为两组（ n=30）。试验组采用手术机器人辅助 TKA（robotic-arm assisted TKA，RATKA），对照组行传统 TKA。两组患者性别、年龄、骨关节炎侧别及病程、体质量指数以及术前髋-膝-踝角（hip-knee-ankle angle，HKA）、股骨远端外侧角（lateral distal femoral angle，LDFA）、胫骨近端内侧角（medial proximal tibial angle，MPTA）、股骨后髁角（posterior condylar angle，PCA）、膝关节学会评分系统-膝关节（KSS-K）及功能（KSS-F）评分比较，差异均无统计学意义（ P>0.05）。比较术后 3 个月两组患者膝关节临床（KSS-K、KSS-F 评分）及影像学（HKA、LDFA、MPTA、PCA）评价指标。. 结果: 两组手术均顺利完成；术后切口均Ⅰ期愈合，无手术相关并发症发生。两组患者均获随访，随访时间 3～6 个月，平均 3.9 个月。两组术后 3 个月 KSS-K 及 KSS-F 评分均较术前提高，差异有统计学意义（ P<0.05）；组间比较差异均无统计学意义（ P>0.05）。术后 X 线片复查示假体位置良好，无假体松动、下沉等不良事件发生。除 LDFA 外，两组术后 3 个月 HKA、MPTA、PCA 均较术前改善，差异有统计学意义（ P<0.05）；HKA、LDFA 及 MPTA 两组间比较，差异均无统计学意义（ P>0.05）；试验组 PCA 小于对照组，且更接近于 0°，差异有统计学意义（ t=2.635， P=0.010）。. 结论: RATKA 不仅能矫正膝关节畸形、减轻疼痛症状、提高患者生活质量，还能达到股骨旋转准确对线，早期疗效满意。.

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