| Background:Total Knee Arthroplasty(TKA)is an important、common and high-level orthopedic surgery,but there are still some problems such as inexact postoperative effect and patients’ dissatisfaction after surgery.A prospective randomized controlled study was conducted to investigate the early clinical efficacy of robot-assisted total knee arthroplasty(RATKA)in the treatment of end-stage knee arthritis,and to compare that with traditional total knee arthroplasty to determine whether RATKA can improve the clinical efficacy and patients’ satisfaction.Methods:A total of 38 patients who planned to undergo knee arthroplasty in the joint surgery ward of our hospital were divided into robotic surgery group(RATKA group)and conventional controlled group(TKA group),with 19 cases in each group.There were no significant differences in scores between the two groups(p>0.05),including age,gender,body weight,BMI,preoperative joint motion,HSS score,KSS score,WOMAC score,Hip-Knee-Ankle Angle(HKA)and other basic general data(P>0.05).The operative time,intraoperative blood loss,postoperative drainage volume,length of stay in hospital,postoperative Hemoglobin(HB)and Hematocrit(HCT)of the two groups were collected and recorded to evaluate the degree of surgical trauma.Knee range of motion(ROM),HSS score,KSS score and WOMAC Pain,Stiffness and Function score were used to evaluate knee joint’ function and recovery of daily life before and after surgery.Hip-Knee-Ankle Angle(HKA),Lateral Distal Femur Angle(LDFA),Medial Proximal Tibial Angle(MPTA),Joint Line Convergence Angle(JLCA)were measured to evaluate the position of prosthesis implantation and lower limb alignment’ rectification.The economic cost of the two groups was evaluated by collecting the total cost of hospitalization,the total cost of imageological examination,the cost of operation,the cost of postoperative analgesic drugs and the cost of postoperative additional analgesic drugs.Results : In the perioperative period,the operation time of RATKA group was exactly longer than that of conventional TKA group(p<0.05),and the intraoperative blood loss of RATKA group significant reduced than that of conventional TKA group,it means statistically significant differences(p<0.05).This was associated with robotic osteotomy,indicating less intraoperative trauma in the RATKA group than in the conventional TKA group,but it also represented the RATKA group extended operative time.The postoperative ROM,HSS and KSS scores and WOMAC Pain,Stiffness and Function scores of both groups were improved after 6 months of follow-up,with statistical significance(p<0.05).The above indexes were compared between the postoperative groups,and there were no statistically significant differences in postoperative WOMAC Pain and Stiffness scores(p>0.05),while there were statistically significant differences in postoperative ROM,HSS,KSS,WOMAC Function and rectification scores(p<0.05).There were no significant differences in postoperative LDFA and MPTA between the two groups(p>0.05),while there were significant differences in postoperative HKA and JLCA between the two groups(p <0.05),especially in the RATKA group,HKA was closer to the ideal value and the correction was more accurate(p < 0.05).By comparing various economic costs between the two groups,it was found that there was a statistically significant difference in the total imageological examination cost during hospitalization(p<0.05),which was related to additional CT examination of hip and knee.There was no statistical significance in the total cost of hospitalization,the cost of surgical items,the cost of postoperative total analgesic drugs,the cost of postoperative additional analgesic drugs and the frequency between the two groups(p<0.05).Conclusion:TKA with Robot-assisted system can improve joint range of motion,the accuracy of prosthesis implantation and rectify lower limb alignment.In the treatment of severe knee arthritis,better early results can be achieved without increasing the economic cost. |
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