ROBOT-ASSISTED TOTAL KNEE ARTHROPLASTY WITH MINIMUM FOLLOW-UP OF NINE YEARS COMPARED WITH CONVENTIONAL TOTAL KNEE ARTHROPLASTY
Notice bibliographique
Résumé
Among many factors that influence the outcomes of Total Knee Arthroplasties (TKAs), the mechanical alignment has played major roles for the success of TKA, the survival rates of the implants, and patient functionality. Most, but not all, studies have shown that alignment of the mechanical axis in the coronal plane within a range of 3° varus/valgus is associated with improved long-term function and increased survival rates. Robot-assisted TKA has been developed to improve improves the accuracy and precision of component implantation and mechanical axis (MA) alignment. We hypothesised that robot-assisted TKA would lead to a more accurate leg alignment and component implantation, and thus, improve radiological and clinical outcomes. Between January 2003 and December 2004, a total of 98 primary TKA procedures were compared: 49 using a robotic-assisted procedure and 49 using conventional manual techniques. The cohorts were followed for 121.2 and 119.5 months on average, respectively. Radiographic assessments of the patients were performed preoperatively and at final follow-up and made according to the Knee Society Roentgenographic Evaluation System (KSRES) which included measurements of the coronal mechanical axis and sagittal and coronal inclinations of femoral and tibial components. The radiographic measurements were made using a PACS (Picture Archiving and Communication System). Clinical assessments were performed preoperatively, and at a final follow-up date that was a minimum of postoperative nine years. The clinical results included ranges of motion (ROM), Hospital for Special Surgery (HSS) scores, Western Ontario and McMaster University (WOMAC) scores (for pain and function). The radiographic results showed no statistical differences when comparing the means of the two groups. When considering outliers (defined as error ≥ ±3°) for the mechanical axis, femoral coronal and sagittal inclinations, and tibial coronal and sagittal inclinations, the ROBODOC group had zero outliers for all measurements except for one in tibial sagittal inclination. On the other hand, the conventional group had 12 outliers for mechanical axis, 2 for femoral coronal inclination, 3 for femoral sagittal inclination, 3 for tibial coronal inclination, and 4 for tibial sagittal inclination. However, there were no statistically significant differences between groups for ROM, HSS, or WOMAC scores at the final follow-up. The results of this study support previous work and demonstrate that the ROBODOC-assisted implantation of TKA results in better radiographic outcomes and better ligament balance with equivalent safety when compared to conventional TKA at a minimum follow-up of nine years.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,001 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».