背景:全髋关节置换术(THA)旨在恢复关节功能并缓解疼痛。新技术,比如机器人辅助,提供了减少人为错误的潜力,提高精度,并改善术后结局。这项研究的目的是比较传统和机器人辅助THA之间的结果。
方法:这是一项利用2016年至2019年国家数据库的回顾性队列研究。接受THA的患者,传统或机器人辅助,是通过国际疾病分类确定的,第十次修订(ICD-10)代码。进行多变量回归以评估组间结果。进行负二项回归以评估出院处置,重新接纳,再操作。使用对数链接的Gamma回归来评估总费用和住院时间。患者人口统计学和合并症,通过Elixhauser合并症指数测量,在我们的分析中被控制了。共有1,216,395名接受THA的患者,18,417(1.51%)在机器人辅助下,已确定。
结果:接受机器人辅助手术的患者手术并发症增加(比值比(OR)1.31[95%CI(置信区间)1.14至1.53];P<0.001),包括假体周围骨折(OR1.63[95%CI1.35至1.98];P<0.001)。值得注意的是,这些患者的总费用也显著增加(OR1.20[95%CI1.11~1.30];P<0.001).
结论:机器人辅助治疗THA与手术并发症风险增加相关,包括假体周围骨折,同时产生更大的费用。
BACKGROUND: Total hip arthroplasty (THA) aims to restore joint function and relieve pain. New technology, such as robot assistance, offers the potential to reduce human error, improve precision, and improve postoperative outcomes. The aim of this study was to compare outcomes between conventional and robot-assisted THA.
METHODS: This is a retrospective cohort study utilizing a national database from 2016 to 2019. Patients undergoing THA, conventional or robot-assisted, were identified via the International Classification of Diseases, Tenth Revision code. Multivariate regressions were performed to assess outcomes between groups. Negative binomial regressions were performed to assess discharge disposition, readmission, and reoperation. Gamma regressions with log-link were used to assess total charges and lengths of hospital stays. Patient demographics and comorbidities, measured via the Elixhauser comorbidity index, were controlled for in our analyses. A total of 1,216,395 patients undergoing THA, 18,417 (1.51%) with robotic assistance, were identified.
RESULTS: Patients undergoing robot-assisted procedures had increased surgical complications (odds ratio [OR] 1.31 [95% confidence interval [CI] 1.14 to 1.53]; P < .001), including periprosthetic fracture (OR 1.63 [95% CI 1.35 to 1.98]; P < .001). Notably, these patients also had significantly greater total charges (OR 1.20 [95% CI 1.11 to 1.30]; P < .001).
CONCLUSIONS: Robotic assistance in THA is associated with an increased risk of surgical complications, including periprosthetic fracture, while incurring greater charges.
METHODS: Level III; Retrospective Cohort Study.