Clinical effects of robot-assisted total knee arthroplasty compared with traditional surgery: a Meta-analysis / 中国骨伤

ABSTRACT

OBJECTIVE@#To compare the difference between robotic-assisted TKA and traditional TKA by Meta-annlysis in order to determine whether robotic-assisted TKA can provide better lower limb force line and clinical prognosis.@*METHODS@#Computerized searches of Embase, Pubmed, Web of Science and CNKI, Wanfang and VIP databases were conducted until November 2018 to find out the difference between robotic assisted TKA and traditional TKA. After screening, quality evaluation and data extraction according to inclusion and exclusion criteria, Revman 5.3 software was used for meta-analysis of literature data.@*RESULTS@#Six clinical controlled studies were included, 253 in robot-assisted TKA group and 231 in traditional TKA group. Meta-analysis showed that the incidence of coronal force line angle[WMD=-1.00, 95%CI(-1.66, -0.35), =0.003], coronal force line inversion or valgus>3°[RR=0.04, 95% CI(0.01, 0.13), =0.000 01] in robot-assisted TKA group was significantly better than that in traditional TKA group, but there were no statistical differences between two groups in range of knee joint motion[WMD=0.06, 95%CI(-5.43, 5.55)], =0.98], anterior position tibial angle[WMD=-0.19, 95% CI(-0.81, 0.43), 95%, =0.55] and lateral tibial angle[WMD=-1.37, 95%CI(-3.73, 0.99), =0.25], anterior position femoral angle[WMD=0.30, 95%CI(-1.37, 1.96), =0.72] and lateral femoral angle[WMD=-0.93, 95%CI(-1.98, 0.013), =0.08], the incidence of complications[RR=0.84, 95%CI(0.45, 1.58), =0.60]. The operation time of robot-cassisted TKA group was longer than that of traditional TKA group[WMD=14.28, 95%CI(0.79, 27.77), =0.04].@*CONCLUSIONS@#The application of robotic assistant system in TKA surgery can significantly improve the accuracy of prosthesis fixation, better reconstruct the lower limb line of force, and has the potential advantages of reducing postoperative pain and promoting the recovery of knee joint function. Due to the limitation of the quantity and quality of the included literature, a high-quality randomized controlled study with long-term follow-up is still needed in the future to support the conclusions of this paper.