Evaluating the impact of robotic-assisted total knee arthroplasty on quality of care through patient-reported outcome measures in a third-level hospital in Italy: A prospective cohort study

IF 1.6 4区医学 Q3 ORTHOPEDICS Knee Pub Date : 2024-11-11 DOI:10.1016/j.knee.2024.10.009

Davide Golinelli , Federico Polidoro , Simona Rosa , Agnese Puzzo , Giovanni Guerra , Stefano Raimondi , Antonio Chiaravalloti , Valentina Sisti , Francesco Sanmarchi , Francesca Bravi , Roberto Grilli , Maria Pia Fantini , Alberto Belluati

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Abstract

Background

With the shift towards personalized medicine, understanding the impact of robotic-assisted total knee arthroplasty (TKA) on patient-reported outcome measures (PROMs) is essential for evaluating its effectiveness and patient satisfaction. The QUAROB (Quality-assessment-of-ROBotic-orthopedic-surgery) study aims at assessing the impact of robotic surgery on quality of care and joint functionality at 6 months post-surgery among patients undergoing robotic-assisted TKA.

Methods

This observational, prospective cohort study included patients from Ravenna Hospital, Italy, who underwent elective robotic TKA (2022–2023), and a historical cohort who underwent traditional TKA (2019). PROMs questionnaires (EuropeanQualityofLife-Visual AnalogScale, EQ-VAS, EuropeanQualityofLife-5Dimensions-3Likert, EQ-5D-3L, and KneeinjuryOsteoarthritisOutcomeScore-PatientSatisfaction, KOOS-PS) were administered within 30 days before surgery and 6 months post-surgery. Statistical analysis involved comparing baseline and follow-up PROMs, focusing on patients achieving at least a 10% improvement (Minimal Clinically Important Difference, MCID).

Results

The study enrolled 214 robotic surgery patients, with 208 completing baseline and 103 completing 6-month follow-up questionnaires. Patients undergoing robotic-assisted TKA demonstrated significant improvements in EQ-VAS, EQ-5D-3L, and KOOS-PS scores at 6 months. A significant proportion of patients achieved improvements exceeding the MCID threshold (68.9% for EQ-VAS, 58.3% for EQ-5D-3L, and 68.9% for KOOS-PS). Robotic TKA patients experienced shorter hospital stays (7 vs. 9 days, p < 0.001) and higher engagement in rehabilitation compared to traditional TKA patients.

Conclusions

The QUAROB study provides evidence of the impact and benefits of robotic-assisted TKA, highlighting significant enhancements in PROMs, reduced hospital stays, and increased rehabilitation engagement. These outcomes reinforce the role of robotic technology in improving surgical precision and patient satisfaction in orthopedic surgery.

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在意大利一家三级医院，通过患者报告的结果指标评估机器人辅助全膝关节置换术对护理质量的影响：前瞻性队列研究。

背景：随着个性化医疗的发展，了解机器人辅助全膝关节置换术（TKA）对患者报告结果指标（PROMs）的影响对于评估其有效性和患者满意度至关重要。QUAROB（Quality-assessment-of-ROBotic-orthopedic-surgery）研究旨在评估机器人手术对接受机器人辅助全膝关节置换术（TKA）的患者术后6个月的护理质量和关节功能的影响：这项前瞻性队列观察研究纳入了意大利拉文纳医院接受择期机器人TKA手术（2022-2023年）的患者，以及接受传统TKA手术（2019年）的历史队列。在手术前30天和手术后6个月内进行了PROMs问卷调查（欧洲生活质量-视觉模拟量表（EQ-VAS）、欧洲生活质量-5维度-3Likert（EQ-5D-3L）和膝关节损伤骨关节炎患者满意度评分（KOOS-PS））。统计分析包括比较基线和随访 PROMs，重点关注至少改善 10%（最小临床意义差异，MCID）的患者：该研究共招募了 214 名机器人手术患者，其中 208 人完成了基线问卷，103 人完成了 6 个月的随访问卷。接受机器人辅助 TKA 手术的患者在 6 个月后的 EQ-VAS、EQ-5D-3L 和 KOOS-PS 评分均有显著改善。相当一部分患者的改善程度超过了MCID阈值（EQ-VAS为68.9%，EQ-5D-3L为58.3%，KOOS-PS为68.9%）。机器人 TKA 患者的住院时间更短（7 天 vs. 9 天，p 结论：机器人 TKA 患者的住院时间更短：QUAROB 研究为机器人辅助 TKA 的影响和益处提供了证据，突出显示了 PROMs 的显著改善、住院时间的缩短和康复参与度的提高。这些结果强化了机器人技术在骨科手术中提高手术精准度和患者满意度的作用。

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来源期刊

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.