Abstract：
OBJECTIVE: The purpose of this study was to examine the effects of intraoperative technology use on the rate of using polyethylene liners 15 mm or greater during primary total knee arthroplasty (TKA).
METHODS: There were 103,295 implants from 16,386 primary unilateral TKAs performed on 14,253 patients at a single institution between 1 January 2018, and 30 June 2022, included in the current study. Robotic assistance and navigation guidance were used in 1274 (8%) and 8345 (51%) procedures, respectively. The remaining 6767 TKAs (41%) were performed manually. Polyethylene liners were manually identified and further subcategorised by implant thickness. Patients who underwent robotic-assisted TKA were younger (p < 0.001) and more likely to be male (p < 0.001) compared to patients who underwent navigation-guided or manual TKAs.
RESULTS: Average polyethylene liner thickness was similar between groups (10.5 ± 1.5 mm for robotic-assisted TKAs, 10.9 ± 1.8 mm for navigation-guided TKAs and 10.8 ± 1.8 mm for manual TKAs). The proportions of polyethylene liners 15 mm or greater used were 4.9%, 3.8% and 1.9% for navigation-guided, manual and robotic-assisted procedures, respectively (p < 0.001). Multivariate regression analyses demonstrated that navigation-guided (odds ratio [OR]: 2.6, 95% confidence Interval [CI]: [1.75-4.07], p < 0.001) and manual (OR: 2.0, 95% CI: [1.34-3.20], p = 0.001) procedures were associated with an increased use of polyethylene liners 15 mm or greater.
CONCLUSIONS: Robotic-assisted TKA was associated with a lower proportion of polyethylene liners 15 mm or greater used compared to navigation-guided and manual TKA. These findings suggest that robotic assistance can reduce human error via a more precise cutting system, limit over-resection of the tibia and flexion-extension gap mismatch and ultimately allow for more appropriately sized implants.
METHODS: Level III, retrospective cohort study.
METHODS: There were 103,295 implants from 16,386 primary unilateral TKAs performed on 14,253 patients at a single institution between 1 January 2018, and 30 June 2022, included in the current study. Robotic assistance and navigation guidance were used in 1274 (8%) and 8345 (51%) procedures, respectively. The remaining 6767 TKAs (41%) were performed manually. Polyethylene liners were manually identified and further subcategorised by implant thickness. Patients who underwent robotic-assisted TKA were younger (p < 0.001) and more likely to be male (p < 0.001) compared to patients who underwent navigation-guided or manual TKAs.
RESULTS: Average polyethylene liner thickness was similar between groups (10.5 ± 1.5 mm for robotic-assisted TKAs, 10.9 ± 1.8 mm for navigation-guided TKAs and 10.8 ± 1.8 mm for manual TKAs). The proportions of polyethylene liners 15 mm or greater used were 4.9%, 3.8% and 1.9% for navigation-guided, manual and robotic-assisted procedures, respectively (p < 0.001). Multivariate regression analyses demonstrated that navigation-guided (odds ratio [OR]: 2.6, 95% confidence Interval [CI]: [1.75-4.07], p < 0.001) and manual (OR: 2.0, 95% CI: [1.34-3.20], p = 0.001) procedures were associated with an increased use of polyethylene liners 15 mm or greater.
CONCLUSIONS: Robotic-assisted TKA was associated with a lower proportion of polyethylene liners 15 mm or greater used compared to navigation-guided and manual TKA. These findings suggest that robotic assistance can reduce human error via a more precise cutting system, limit over-resection of the tibia and flexion-extension gap mismatch and ultimately allow for more appropriately sized implants.
METHODS: Level III, retrospective cohort study.
摘要：
目的：这项研究的目的是检查术中技术使用对初次全膝关节置换术（TKA）期间使用15mm或更大的聚乙烯衬里的比率的影响。
方法：在2018年1月1日至2022年6月30日期间，在一个机构对14,253例患者进行了16,386例原发性单侧TKAs的103,295例植入物，包括在本研究中。1274例（8%）和8345例（51%）手术中使用了机器人辅助和导航引导，分别。其余的6767个TKAs(41%)是手动进行的。手动鉴定聚乙烯衬垫,并通过植入物厚度进一步分类。与接受导航引导或手动TKA的患者相比，接受机器人辅助TKA的患者更年轻（p<0.001），更可能是男性（p<0.001）。
结果：两组之间的平均聚乙烯衬里厚度相似（对于机器人辅助的TKA，为10.5±1.5mm，导航导航TKA为10.9±1.8mm，手动TKA为10.8±1.8mm）。使用的15毫米或更大的聚乙烯衬里的比例为4.9％，导航导航占3.8%和1.9%，手动和机器人辅助程序，分别(p<0.001)。多变量回归分析表明，导航引导(比值比[OR]：2.6，95%置信区间[CI]：[1.75-4.07]，p<0.001）和手动（OR：2.0，95%CI：[1.34-3.20]，p=0.001）程序与15mm或更大的聚乙烯衬里的使用增加有关。
结论：与导航引导和手动TKA相比，机器人辅助的TKA与使用15mm或更大的聚乙烯衬里的比例较低相关。这些发现表明，机器人辅助可以通过更精确的切割系统减少人为错误。限制胫骨的过度切除和屈伸间隙不匹配，并最终允许尺寸更合适的植入物。
方法：三级，回顾性队列研究。
方法：在2018年1月1日至2022年6月30日期间，在一个机构对14,253例患者进行了16,386例原发性单侧TKAs的103,295例植入物，包括在本研究中。1274例（8%）和8345例（51%）手术中使用了机器人辅助和导航引导，分别。其余的6767个TKAs(41%)是手动进行的。手动鉴定聚乙烯衬垫,并通过植入物厚度进一步分类。与接受导航引导或手动TKA的患者相比，接受机器人辅助TKA的患者更年轻（p<0.001），更可能是男性（p<0.001）。
结果：两组之间的平均聚乙烯衬里厚度相似（对于机器人辅助的TKA，为10.5±1.5mm，导航导航TKA为10.9±1.8mm，手动TKA为10.8±1.8mm）。使用的15毫米或更大的聚乙烯衬里的比例为4.9％，导航导航占3.8%和1.9%，手动和机器人辅助程序，分别(p<0.001)。多变量回归分析表明，导航引导(比值比[OR]：2.6，95%置信区间[CI]：[1.75-4.07]，p<0.001）和手动（OR：2.0，95%CI：[1.34-3.20]，p=0.001）程序与15mm或更大的聚乙烯衬里的使用增加有关。
结论：与导航引导和手动TKA相比，机器人辅助的TKA与使用15mm或更大的聚乙烯衬里的比例较低相关。这些发现表明，机器人辅助可以通过更精确的切割系统减少人为错误。限制胫骨的过度切除和屈伸间隙不匹配，并最终允许尺寸更合适的植入物。
方法：三级，回顾性队列研究。
