ABSTRACT
OBJECTIVE@#To investigate the early efficacy of Mako robot-assisted total knee arthroplasty (TKA) in the treatment of knee osteoarthritis (KOA) and summarize the initial application experience.@*METHODS@#Retrospective analysis of 73 patients with KOA treated with Mako robot-assisted TKA from June 2021 to December 2021. There were 16 males and 57 females, aged from 54 to 81 years old with an average of (67.8±6.6) years old. The hip knee and ankle angle (HKA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), lateral femoral component angle (LFCA) and lateral tibial component angle (LTCA) were recorded and analyzed. WOMAC score and KSS were used to compare the functional recovery of patients preoperatively, 3 and 6 months postoperatively.@*RESULTS@#All the 73 patients were successfully treated without serious complications such as vascular and nerve injury, and all the incisions healed well at stageⅠwithout infection. The patients were followed up from 4 to 11 months with an average of (7.0±2.7) months, and the satisfaction rate of the last follow-up was 90.41% (66/73). WOMAC scores were (23.1±5.4) at 3 months and (14.8±4.1) at 6 months postoperatively. KSS clinical scores were ( 76.1±4.0) at 3 months and (82.1±3.7) at 6 months postoperatively;KSS functional scores were (74.3±3.1) at 3 months and (78.6±2.1) at 6 months after operation. Postoperative imaging showed good position of the prosthesis, HKA angle was (178.5±2.1)°, LDFA was (91.2±1.8)°, MPTA was(89.9±1.5) °, LFCA was (7.6±3.1)°, LTCA was (88.2±1.1)°. The mechanical axis within ±3° in sixty cases(82.2%), and the mechanical axis within ±6° in all the patients.@*CONCLUSION@#Mako robot-assisted TKA is a safe and effective surgery in the treatment of knee osteoarthritis, which exhibited good efficacy in the correction of lower limb alignment, soft tissue balance and improvement of knee function. The long-term efficacy needs further follow-up observation.
Subject(s)
Male , Female , Humans , Middle Aged , Aged , Aged, 80 and over , Arthroplasty, Replacement, Knee/methods , Osteoarthritis, Knee/surgery , Retrospective Studies , Robotics , Knee Joint/surgeryABSTRACT
BACKGROUND: With the maturity of total hip arthroplasty, the need for operative accuracy is highly increasingto get better operative results. The joint replacement technique assisted by MAKO robot makes the precision of the operation possible. However, this technology has a certain learning curve, and early replacement results and complications should be the major concern. OBJECTIVE: To analyze the learning curve and early clinical results of total hip arthroplasty through the posterolateral approach assisted by the MAKO robot. METHODS: From March 2017 to March 2018, 26 patients undergoing hip arthroplasty via posterolateral approach assisted by MAKO robots in West Hospital (Haikou Orthopedics and Diabetes Hospital), Haikou Hospital, Xiangya School of Medicine, Central South University, including 12 males and 14 females, were retrospectively analyzed. The problems and early clinical outcomes of hip replacement in the early learning curve were focused on. RESULTS AND CONCLUSION: The operation time was 56-155 minutes, mean (87.0 ± 16.1) minutes. The dominant bleeding was 220-850 mL, mean (336±246) mL. The acetabular abduction angle was (41,3±2.7)°. The acetabular anteversion angle was (16.4±3.4)°. The difference in lower limb length was (1,0±2.0) mm, and the femoral offset error value was (1.6±0.6) mm. Intraoperative femoral fractures occurred in one case. No infection, sciatic nerve injury or wound-related complications occurred. The weight bearing time was 3-6 weeks, mean (3.8±2.1) weeks. Harris score was (92.1 ±4.7) 3 months after surgery. It is indicated that the MAKO robot-assisted total hip arthroplasty via posterolateral approach showed that patient’s postoperative pain improved; the function recovered quickly; the clinical results were good; the operation time decreased with the proficiency; the prosthesis position was within the safe range; and the blood loss was within the acceptable range.
ABSTRACT
Objective: To investigate the efficacy of total hip arthroplasty (THA) assisted by the MAKO robotic arm via posterolateral approach. Methods: The clinical data of 70 patients treated with THA via posterolateral approach between March 2017 and March 2019 who met the selection criteria were retrospectively analyzed. According to different treatment methods, the patients were divided into two groups, 35 were treated with MAKO robotic arm assisted THA (MAKO group) and 35 with traditional THA (THA group). There was no significant difference in gender, age, body mass index, disease duration, etiology, perioperative time, preoperative activity of daily living (ADL) scale index, American Society of Anesthesiologists (ASA) classification, walking ability, comorbidities, hemoglobin, and other general data between the two groups ( P>0.05). The operation time, intraoperative blood loss, hospital stay, postoperative acetabular abduction and anteversion angles, postoperative length difference of bilateral lower limbs, and proportions of intraoperative blood transfusion, immediate postoperative loading, wound drainage time more than 2 days, and complications were recorded and compared between the two groups. According to the X-ray films at 6 months after operation, the reduction quality was judged. The forgotten joint score, Harris score, and proportions of independent walking and ADL index increased were used to evaluate the function recovery of patients. Results: Patients in both groups were followed up 6-18 months, with an average of 8 months. There was no significant difference ( P>0.05) between the two groups in operation time, intraoperative blood loss, hospital stay, acetabular abduction and anteversion angles, and length difference of both lower limbs at 6 months after operation. There was no significant difference in the proportions of intraoperative blood transfusion, immediate postoperative loading, and wound drainage time more than 2 days between the two group ( P>0.05). X-ray reexamination at 6 months after operation showed that there was no significant difference in the reduction quality between the two groups ( Z=4.191, P=0.123). Postoperative complications occurred in 7 patients (20.0%) in the MAKO group and 10 patients (28.6%) in the THA group, showing no significant difference in the incidence of complications between the two groups ( χ2=2.121, P=0.224). Two patients (5.7%) in the MAKO group and 4 patients (11.4%) in the THA group underwent revision within 6 months, showing no significant difference in the revision rate between the two groups ( χ2=0.729, P=0.673). At 3 and 6 months after operation, the proportions of independent walking and ADL index increased showed no significant difference between the two groups ( P>0.05). Harris scores in both groups improved significantly when compared with preoperative scores ( P0.05). Conclusion: Compared with traditional THA, MAKO robotic arm assisted THA has longer operation time and more intraoperative blood loss, but it has the advantages of accurate positioning and simple operation, and there is no significant difference in short-term postoperative function recovery.