본문 바로가기
KERD
논문KCI 등재

Robotic-assisted vs conventional surgery in medial unicompartmental knee arthroplasty: a clinical and radiological study

Negrín Roberto|Duboy Jaime|Iñiguez Magaly|Reyes Nicolás O.|Barahona Maximiliano|Ferrer Gonzalo|Infante Carlos|Jabes Nicolás
대한슬관절학회 (Korean Knee Society)|2021.12|Knee Surgery and Related Research|제33권 |pp. 5-5|DOI 10.1186/s43019-021-00087-2

2

조회

0

다운로드

1

인용

0

참고문헌

키워드

Robotic-assisted surgeryUnicompartmental knee

초록

The use of unicompartmental knee arthroplasty (UKA) has increased and new technologies have been developed to improve patient survival and satisfaction, soft tissue balance, alignment, and component size. Robot-assisted systems offer an increase in surgical precision and accuracy. The purpose of this study is to evaluate the precision of component position using five radiological parameters in conventional and robotic-assisted medial UKA using the NAVIO system.A cohort study was designed for patients who underwent medial UKA between April 2017 and March 2019 in a single center. Patients were allocated in the conventional (UKA-C) or robotic-assisted (UKA-R) group. The variables analyzed were age, gender, affected knee side, length of hospital stay, surgical time, and radiological measurements such as anatomical medial distal femoral angle (aMDFA), anatomical medial proximal tibial angle (aMPTA), tibial slope, the sagittal femoral angle, and the component size. A target was defined for each measurement, and a successful UKA was defined if at least four radiological measures were on target after surgery. Also, patients’ reported outcomes were evaluated using the Oxford Knee Score (OKS) and a numeric rating scale (NRS) for pain. Thirty-four patients were included, 18 of them underwent UKA-R. The success rate for UKA in the UKA-R group was 87%; meanwhile, in the UKA-C group this was 28%, this difference was significant and powered (Fisher’s exact test, p = 0.001; 1 − β = 0.95). Also, a 5-point difference in favor of the UKA-R group in the median OKS ( p = 0.01), and a significantly lower median NRS for pain ( p < 0.000) were found after surgery. UKA-R achieved more precision in the radiological parameters’ measure in this study. Also, UKA-R has a trend towards a better OKS and a lower NRS for pain at short-term follow-up.

Abstract

The use of unicompartmental knee arthroplasty (UKA) has increased and new technologies have been developed to improve patient survival and satisfaction, soft tissue balance, alignment, and component size. Robot-assisted systems offer an increase in surgical precision and accuracy. The purpose of this study is to evaluate the precision of component position using five radiological parameters in conventional and robotic-assisted medial UKA using the NAVIO system.A cohort study was designed for patients who underwent medial UKA between April 2017 and March 2019 in a single center. Patients were allocated in the conventional (UKA-C) or robotic-assisted (UKA-R) group. The variables analyzed were age, gender, affected knee side, length of hospital stay, surgical time, and radiological measurements such as anatomical medial distal femoral angle (aMDFA), anatomical medial proximal tibial angle (aMPTA), tibial slope, the sagittal femoral angle, and the component size. A target was defined for each measurement, and a successful UKA was defined if at least four radiological measures were on target after surgery. Also, patients’ reported outcomes were evaluated using the Oxford Knee Score (OKS) and a numeric rating scale (NRS) for pain. Thirty-four patients were included, 18 of them underwent UKA-R. The success rate for UKA in the UKA-R group was 87%; meanwhile, in the UKA-C group this was 28%, this difference was significant and powered (Fisher’s exact test, p = 0.001; 1 − β = 0.95). Also, a 5-point difference in favor of the UKA-R group in the median OKS ( p = 0.01), and a significantly lower median NRS for pain ( p < 0.000) were found after surgery. UKA-R achieved more precision in the radiological parameters’ measure in this study. Also, UKA-R has a trend towards a better OKS and a lower NRS for pain at short-term follow-up.

참고문헌 (37)

  1. Lawrence RC, "Estimates of the prevalence of arthritis and other rheumatic conditions in the United States:part II", Arthritis Rheum, 58, pp.26~35 (2008)
  2. Vos T, "Years lived with disability(YLDs)for 1160 sequelae of 289 diseases and injuries 1990-2010 : a systematic analysis for the Global Burden of Disease Study 2010", Lancet, 380, pp.2163~2196 (2012)
  3. Bijlsma JWJ, "Osteoarthritis : an update with relevance for clinical practice", Lancet, 377, pp.2115~2126 (2011)
  4. Nguyen US, "Increasing prevalence of knee pain and symptomatic knee osteoarthritis : survey and cohort data", Ann Intern Med, 155(11), pp.725~732 (2011)
  5. Felson DT, "Osteoarthritis : new insights. Part 1 : the disease and its risk factors", Ann Intern Med, 133(8), pp.635~646 (2000)
  6. Loeser RF, "Ageing and the pathogenesis of osteoarthritis", Nat Rev Rheumatol, 12, pp.412~420 (2016)
  7. Abbott JH, "The quality-of-life burden of knee osteoarthritis in New Zealand adults : a model-based evaluation", PLoS One, 12(10), pp.e0185676~ (2017)
  8. Wallace IJ, "Knee osteoarthritis has doubled in prevalence since the mid-20th century", Proc Natl Acad Sci U S A, 114(35), pp.9332~9336 (2017)
  9. Bolognesi MP, "Unicompartmental knee arthroplasty and total knee arthroplasty among Medicare beneficiaries, 2000 to 2009", J Bone Joint Surg Am, 95(22), pp.e174~ (2013)
  10. Swank ML, "Technology and costeffectiveness in knee arthroplasty: computer navigation and robotics", Am J Orthop (Belle Mead NJ), 38(2 Suppl), pp.32~36 (2009)
  11. "Hip and knee arthroplasty annual report 2018"[URL]
  12. "The New Zealand Registry annual report" (2018)[URL]
  13. "Annual report - Swedish Knee Arthroplasty Register 2018"[URL]
  14. "15th annual report 2018"[URL]
  15. Schwab PE, "Lower blood loss after unicompartmental than total knee arthroplasty", Knee Surg Sports Traumatol Arthrosc, 23(12), pp.3494~3500 (2015)
  16. Watanabe T, "In vivo kinematics of a robot-assisted uni-and multicompartmental knee arthroplasty", J Orthop Sci, 19(4), pp.552~557 (2014)
  17. Larsen K, "Accelerated perioperative care and rehabilitation intervention for hip and knee replacement is effective : a randomized clinical trial involving 87patients with 3 months of follow-up", Acta Orthop, 79(2), pp.149~159 (2008)
  18. McAllister CM, "The role of unicompartmental knee arthroplasty versus total knee arthroplasty in providing maximal performance and satisfaction", J Knee Surg, 21(4), pp.286~292 (2008)
  19. Iñiguez M, "Robot-assisted unicompartmental knee arthroplasty: increasing surgical accuracy? A cadaveric study", J Knee Surg (2019)[DOI]
  20. van der List JP, "Current state of computer navigation and robotics in unicompartmental and total knee arthroplasty: a systematic review with meta-analysis", Knee Surg Sports Traumatol Arthrosc, 24(11), pp.3482~3495 (2016)
  21. Barbadoro P, "Giannini S Tibial component alignment and risk of loosening in unicompartmental knee arthroplasty : a radiographic and radiostereometric study", Knee Surg Sports Traumatol Arthrosc, 22(12), pp.3157~3162 (2014)
  22. Jenny JY, "Unicompartmental knee prosthesis implantation with a non-image-based navigation system: rationale, technique, casecontrol comparative study with a conventional instrumented implantation", Knee Surg Sports Traumatol Arthrosc, 11(1), pp.40~45 (2003)
  23. Pearle AD, "Survivorship and patient satisfaction of robotic-assisted medial unicompartmental knee arthroplasty at a minimum two-year follow-up", Knee, 24(2), pp.419~428 (2017)
  24. Batailler C, "Improved implant position and lower revision rate with robotic-assisted unicompartmental knee arthroplasty", Knee Surg Sports Traumatol Arthrosc, 27(4), pp.1232~1240 (2019)
  25. Kleeblad LJ, "Midterm survivorship and patient satisfaction of robotic-arm-assisted medial unicompartmental knee arthroplasty : a multicenter study", J Arthroplasty, 33(6), pp.1719~1726 (2018)
  26. Winnock de Grave P, "Outcomes of a fixed-bearing, medial, cemented unicondylar knee arthroplasty design : survival analysis and functional score of 460 cases", J Arthroplasty, 33(9), pp.2792~2799 (2018)
  27. Lombardi AV Jr, "Is recovery faster for mobile-bearing unicompartmental than total knee arthroplasty?", Clin Orthop Relat Res, 467(6), pp.1450~1457 (2009)
  28. Fu J, "Robot-assisted vs. conventional unicompartmental knee arthroplasty: systematic review and meta-analysis. Roboterassistierte vs. konventionelle unikompartimentäre knieendoprothese:systematisches review und metaanalyse", Orthopade, 47(12), pp.1009~1017 (2018)
  29. Robinson PG, "A systematic review of robotic-assisted unicompartmental knee arthroplasty: prosthesis design and type should be reported", Bone Joint J, 101-B(7), pp.838~847 (2019)
  30. Cobb J, "Hands-on robotic unicompartmental knee replacement : a prospective, randomised controlled study of the acrobot system", J Bone Joint Surg Br, 88(2), pp.188~197 (2006)
  31. Weber P, "Improved accuracy in computer-assisted unicondylar knee arthroplasty : a meta-analysis", Knee Surg Sports Traumatol Arthrosc, 21(11), pp.2453~2461 (2013)
  32. Lonner JH, "High degree of accuracy of a novel image-free handheld robot for unicondylar knee arthroplasty in a cadaveric study", Clin Orthop Relat Res, 473(1), pp.206~212 (2015)
  33. Blyth MJG, "Robotic arm-assisted versus conventional unicompartmental knee arthroplasty: exploratory secondary analysis of a randomised controlled trial", Bone Joint Res, 6(11), pp.631~639 (2017)
  34. Bell SW, "Improved accuracy of component positioning with robotic-assisted unicompartmental knee arthroplasty : data from a prospective, randomized controlled study", J Bone Joint Surg Am, 98(8), pp.627~635 (2016)[DOI]
  35. St Mart JP, "The three-year survivorship of robotically assisted versus non-robotically assisted unicompartmental knee arthroplasty", Bone Joint J, 102-B(3), pp.319~328 (2020)
  36. Mergenthaler G, "Is roboticassisted unicompartmental knee arthroplasty a safe procedure? A case control study", Knee Surg Sports Traumatol Arthrosc (2020)[DOI]
  37. Ponzio DY, "Preoperative mapping in unicompartmental knee arthroplasty using computed tomography scans is associated with radiation exposure and carries high cost", J Arthroplasty, 30(6), pp.964~967 (2015)

관련 논문AI추천

Comparison of 1-year outcomes between MAKO versus NAVIO robot-assisted medial UKA: nonrandomized, prospective, comparative studyArirachakaran Alisara, Kongtharvonskul Jatupon, Leelasestaporn Chumroonkiet, Tarnpichprasert Tomorn대한슬관절학회 · Knee Surgery and Related Research2020 · 제32권 Evidence-based surgical technique for medial unicompartmental knee arthroplastyChoi Sang Min, Kim Tae Kyun, Kim Woo Hyun, Meshram Prashant, Mittal Anurag대한슬관절학회 · Knee Surgery and Related Research2021 · 제33권 Preserving coronal knee alignment of the knee (CPAK) in unicompartmental knee arthroplasty correlates with superior patient-reported outcomes윤국로, 이명철, 이재민, Hyuk‑Soo Han, Sung Eun Kim대한슬관절학회 · Knee Surgery and Related Research2024 · 제36권 Management of failed UKA to TKA: conventional versus robotic-assisted conversion techniqueChen Chang-Hwa Mary, Pasko Kory B. Dylan, Qutami Marilena, Yun Andrew G.대한슬관절학회 · Knee Surgery and Related Research2020 · 제32권 The Influence of Postoperative Tibiofemoral Alignment on the Clinical Results of Unicompartmental Knee ArthroplastyJung Soo Lee, Kyung Hwan Boo, Kyung Tae Kim, Song Lee, Tae Woo Kim대한슬관절학회 · Knee Surgery and Related Research2012 · 제24권 제2호Intramedullary rod insertion places the femoral component more laterally during Oxford medial unicompartmental knee arthroplastyAkira Saito, Koji Okamoto, Takaaki Fuishiro, Takafumi Hiranaka, Tomoyuki kamenaga, Toshikazu Tanaka, Yoshihito Suda대한슬관절학회 · Knee Surgery and Related Research2022 · 제34권

이 간행물의 다른 논문 (46건)

A systematic review comparing the results of early vs delayed ligament surgeries in single anterior cruciate ligament and multiligament knee injuries박용범, Lee Han-Jun, Pujol Nicolas, Han Sang-Jin, Kim Seong Hwan, Kim Dong-Hyunpp. 1-1Evidence-based surgical technique for medial unicompartmental knee arthroplastyChoi Sang Min, Mittal Anurag, Meshram Prashant, Kim Woo Hyun, Kim Tae Kyunpp. 2-2Outcomes of one-stage reconstruction for chronic multiligament injuries of kneeGoyal Tarun, Paul Souvik, Banerjee Sushovan, Das Lakshmanapp. 3-3Change of joint-line convergence angle should be considered for accurate alignment correction in high tibial osteotomy심재앙, Na Young Gon, Lee Beom Koo, Choi Ji Uk, Lee Byung Hoonpp. 4-4Systematic review: total knee arthroplasty (TKA) in patients with pigmented villonodular synovitis (PVNS)Tsitskaris Konstantinos, Tan Jia Yin, Tan Yi Chuenpp. 6-6
원문 보기