Luca Andriollo, Francesco Benazzo, Virgina Cinelli, Rudy Sangaletti, Calogero Vellutto, Stefano Marco Paolo Rossi
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All patients were clinically evaluated preoperatively and at the final follow-up of 31.3 ± 12.1 months, using the Western Ontario and McMaster Universities Arthritis Index (WOMAC), Oxford Knee Score (OKS), Forgotten Joint Score (FJS-12), Numerical Rating Scale (NRS) and range of motion (ROM). Additionally, a radiographic evaluation was performed, and implant survival was assessed by analyzing complications at final follow-up.</p><p><strong>Results: </strong>In 88.6% of the patients, a primary Posterior Stabilized (PS) or Constrained Posterior Stabilized prosthetic implant was used, with 11.4% of patients requiring a varus-valgus constraint implant. In 71.4% of the cases, a thinnest size liner of 10 mm was used. The use of the robotic system was never aborted for any reason. At final follow-up, the implant survival rate was 97.14%. 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引用次数: 0
摘要
目的：机器人技术在关节翻修成形术中的应用，特别是从单腔膝关节置换术（UKA）到全膝关节置换术（TKA）的应用尚不充分。本研究的目的是描述无图像机器人系统的手术技术，用于将UKA修改为TKA，并评估短期到中期的结果。方法：该前瞻性研究包括2020年5月至2023年7月接受治疗的35例患者。收集患者的人口统计资料并评估需要翻修手术的原因。所有患者术前和最终随访31.3±12.1个月时均采用Western Ontario and McMaster university Arthritis Index （WOMAC）、Oxford Knee Score （OKS）、Forgotten Joint Score （FJS-12）、Numerical Rating Scale （NRS）和活动度（ROM）进行临床评估。此外，还进行了影像学评估，并通过分析最终随访时的并发症来评估种植体的存活。结果：在88.6%的患者中，使用了初级后路稳定（PS）或约束后路稳定假体植入物，11.4%的患者需要内翻约束植入物。在71.4%的病例中，使用了最薄的10mm尺寸的衬垫。机器人系统的使用从未因任何原因而中断。最终随访时，种植体成活率为97.14%。平均OKS由31.4±9.4上升至41.5±4.3，FJS-12由47.3±19.3上升至80.7±8.9；最终随访时WOMAC为17.8±8.7，术前为53.5±21.3。分析ROM、NRS和患者报告的结局指标，术前和最终随访时各参数均有显著差异。结论：本研究强调，在一组接受机器人辅助从UKA到TKA转换的患者中，使用基于功能理念的无图像手术结合术中骨变形和对齐已被证明是安全的，并产生了良好的临床和放射学结果。证据等级：II级，前瞻性队列研究。
The use of an imageless robotic system in revision of unicompartmental knee arthroplasty.
Purpose: The application of robotics in revision arthroplasty particularly from unicompartmental knee arthroplasty (UKA) to total knee arthroplasty (TKA), is underexplored. The purpose of this study is to describe the surgical technique of an imageless robotic system used in the revision of UKA to TKA and to evaluate short- to mid-term outcomes.
Methods: This prospective study includes 35 patients treated from May 2020 to July 2023. Demographic data of the patients were gathered and the reasons for needing revision surgery were assessed. All patients were clinically evaluated preoperatively and at the final follow-up of 31.3 ± 12.1 months, using the Western Ontario and McMaster Universities Arthritis Index (WOMAC), Oxford Knee Score (OKS), Forgotten Joint Score (FJS-12), Numerical Rating Scale (NRS) and range of motion (ROM). Additionally, a radiographic evaluation was performed, and implant survival was assessed by analyzing complications at final follow-up.
Results: In 88.6% of the patients, a primary Posterior Stabilized (PS) or Constrained Posterior Stabilized prosthetic implant was used, with 11.4% of patients requiring a varus-valgus constraint implant. In 71.4% of the cases, a thinnest size liner of 10 mm was used. The use of the robotic system was never aborted for any reason. At final follow-up, the implant survival rate was 97.14%. Average OKS increased from 31.4 ± 9.4 to 41.5 ± 4.3, FJS-12 from 47.3 ± 19.3 to 80.7 ± 8.9; WOMAC at final follow-up was 17.8 ± 8.7, from 53.5 ± 21.3 preoperatively. Analyzing ROM, NRS and patient-reported outcome measures, there were significant differences in each parameter between prerevision surgery and final follow-up.
Conclusions: This study highlights that in a cohort of patients undergoing robotic-assisted conversion from UKA to TKA, the use of an imageless procedure incorporating intraoperative bone morphing and alignment based on a functional philosophy has proven to be safe and has yielded excellent clinical and radiographic outcomes.
Level of evidence: Level II, prospective cohort study.
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).
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