Comparison of early clinical outcomes between domestic robot-assisted total knee arthroplasty and traditional surgery: Meta analysis of randomized controlled trials
10.3760/cma.j.cn115530-20230523-00255
- VernacularTitle:国产机器人辅助与传统人工全膝关节置换术早期临床效果的比较：随机对照试验Meta分析
- Author:
Yongze YANG
1
;
Qinghao CHEN
;
Anren ZHANG
;
Xin YANG
;
Zhuangzhuang ZHANG
;
Hua FAN
;
Fukang ZHANG
;
Hongzhang GUO
Author Information
1. 甘肃中医药大学第一临床医学院，兰州 780000
- Keywords:
Arthroplasty, replacement, knee;
Treatment outcome;
Meta-analysis;
Domestic robotics
- From:
Chinese Journal of Orthopaedic Trauma
2023;25(12):1064-1073
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the early clinical outcomes between domestic robot-assisted total knee arthroplasty (RA-TKA) and conventional manual total knee arthroplasty (CM-TKA) for patients with primary knee osteoarthritis.Methods:Embase, Pubmed, Web of Science, Zhi.com and Wanfang databases from January 2015 to April 2023 were searched for clinical controlled trials (RCTs) comparing the clinical outcomes between RA-TKA and CM-TKA. After literature screening, quality evaluation and data extraction according to the criteria required, Revman 5.3 software was applied to perform a Meta-analysis of the literature data. The operation time, intraoperative bleeding, hip-knee-ankle angle (HKA), HKA bias value, frontal femoral component (FFC), frontal tibia component (FTC), lateral femoral component (LFC), lateral tibia component (LTC), Knee Society Score (KSS), visual analogue scale (VAS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), knee mobility, Hospital for Specialty Surgery (HSS) knee score, length of hospital stay, and rate of complications were compared between the RA-TKA and CM-TKA patients.Results:Eight RCTs and 449 patients were included, with 221 patients in the RA-TKA group and 228 ones in the CM-TKA group. The Meta-analysis showed that the RA-TKA group had significantly longer operation time ( MD=18.41, 95% CI: 11.28 to 25.23, P<0.001), significantly better HKA ( MD=0.41, 95% CI: 0.06 to 0.76, P=0.020), significantly better HKA bias value ( MD=-0.92, 95% CI: -1.25 to -0.60, P<0.001), significantly better FTC ( MD=0.38, 95% CI: 0.08 to 0.67, P=0.010), significantly better LTC ( MD=1.71, 95% CI: 0.94 to 2.48, P<0.001), and significantly better knee mobility ( MD=-2.23, 95% CI: -4.18~-0.27, P=0.030) than the CM-TKA group. However, the differences were not statistically significant between the 2 groups in the intraoperative bleeding, FFC, LFC, KSS, VAS, WOMAC, HSS, length of hospital stay, or rate of complications ( P>0.05). Conclusion:Use of a domestic robot to assist conventional manual TKA can significantly improve the accuracy of prosthesis fixation and reconstruct the alignment of lower limb better, showing potential advantages in promoting functional recovery of the knee for the patients.
