5-Year Survivorship and Outcomes of Robotic-Arm-Assisted Medial Unicompartmental Knee Arthroplasty
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Résumé
Purpose. While unicompartmental knee arthroplasty (UKA) has demonstrated benefits over total knee arthroplasty (TKA) in selected populations, component placement continues to be challenging with conventional surgical instruments, resulting in higher early failure rates. Robotic-arm-assisted UKA (RA-UKA) has shown to be successful in component positioning through preop planning and intraop adjustability. The purpose of this study is to assess the 5-year clinical outcomes of medial RA-UKA. Methods. This study was a retrospective review of a single-center prospectively maintained cohort of 133 patients (146 knees) indicated for medial UKA from 2009 to 2013. Perioperative data and 2- and 5-year Knee injury Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities Osteoarthritis Score (WOMAC), and Forgotten Joint Score (FJS) outcome measures were collected. Five-year follow-up was recorded in 119 patients (131 knees). Results. Mean follow-up was <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"> <a:mn>5.1</a:mn> <a:mo>±</a:mo> <a:mn>0.2</a:mn> </a:math> years. Mean age and BMI were <c:math xmlns:c="http://www.w3.org/1998/Math/MathML" id="M2"> <c:mn>68.0</c:mn> <c:mo>±</c:mo> <c:mn>8.1</c:mn> </c:math> years and <e:math xmlns:e="http://www.w3.org/1998/Math/MathML" id="M3"> <e:mn>29.3</e:mn> <e:mo>±</e:mo> <e:mn>4.7</e:mn> </e:math> kg/m2, respectively. At 2-year follow-up, mean KOOS, WOMAC, and FJS were <g:math xmlns:g="http://www.w3.org/1998/Math/MathML" id="M4"> <g:mn>71.5</g:mn> <g:mo>±</g:mo> <g:mn>15.3</g:mn> </g:math> , <i:math xmlns:i="http://www.w3.org/1998/Math/MathML" id="M5"> <i:mn>14.3</i:mn> <i:mo>±</i:mo> <i:mn>7.9</i:mn> </i:math> , and <k:math xmlns:k="http://www.w3.org/1998/Math/MathML" id="M6"> <k:mn>79.1</k:mn> <k:mo>±</k:mo> <k:mn>25.8</k:mn> </k:math> , respectively. At 5-year follow-up, mean KOOS, WOMAC, and FJS were <m:math xmlns:m="http://www.w3.org/1998/Math/MathML" id="M7"> <m:mn>71.6</m:mn> <m:mo>±</m:mo> <m:mn>15.2</m:mn> </m:math> , <o:math xmlns:o="http://www.w3.org/1998/Math/MathML" id="M8"> <o:mn>14.2</o:mn> <o:mo>±</o:mo> <o:mn>7.9</o:mn> </o:math> , and <q:math xmlns:q="http://www.w3.org/1998/Math/MathML" id="M9"> <q:mn>80.9</q:mn> <q:mo>±</q:mo> <q:mn>25.1</q:mn> </q:math> , respectively. Mean change in KOOS and WOMAC was <s:math xmlns:s="http://www.w3.org/1998/Math/MathML" id="M10"> <s:mn>34.6</s:mn> <s:mo>±</s:mo> <s:mn>21.4</s:mn> </s:math> and <u:math xmlns:u="http://www.w3.org/1998/Math/MathML" id="M11"> <u:mn>11.0</u:mn> <u:mo>±</u:mo> <u:mn>13.6</u:mn> </u:math> , respectively ( <w:math xmlns:w="http://www.w3.org/1998/Math/MathML" id="M12"> <w:mi>p</w:mi> <w:mo><</w:mo> <w:mn>0.001</w:mn> </w:math> and <y:math xmlns:y="http://www.w3.org/1998/Math/MathML" id="M13"> <y:mi>p</y:mi> <y:mo><</y:mo> <y:mn>0.001</y:mn> </y:math> ). For patient satisfaction at last follow-up, 89% of patients were very satisfied/satisfied and 5% were dissatisfied. For patient activity expectations at last follow-up, 85% met activity expectations, 52% were more active than before, 25% have the same level of activity, 23% were less active than before, and 89% were walking without support. All patients returned to driving after surgery at a mean <ab:math xmlns:ab="http://www.w3.org/1998/Math/MathML" id="M14"> <ab:mn>15.2</ab:mn> <ab:mo>±</ab:mo> <ab:mn>9.4</ab:mn> </ab:math> days. Survivorship was 95% (95% CI 0.91-0.98) at 5 years. One knee (1%) had a patellofemoral revision, two knees (1.3%) were revised to different partial knee replacements, and five knees (3.4%) were converted to TKA. Conclusion. Overall, medial RA-UKA demonstrated improved patient-recorded outcomes, high patient satisfaction, met expectations, and excellent functional recovery. Midterm survivorship was excellent. Longitudinal follow-up is needed to evaluate long-term outcomes of robotic-arm-assisted UKA procedures.
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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 | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 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 découle