SAN FRANCISCO, Feb. 14, 2024 /PRNewswire/ -- The use of robotics is becoming increasingly common in joint replacement, but more research is needed to quantify its benefits. HSS investigators presented two retrospective studies at the American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting in San Francisco analyzing outcomes in both knee and hip replacement surgeries performed with robotic assistance..

旧金山，2024年2月14日/PRNewswire/--机器人技术在关节置换中的应用越来越普遍，但需要更多的研究来量化其益处。HSS研究人员在旧金山举行的美国骨科医师学会（AAOS）年会上提交了两项回顾性研究，分析了在机器人辅助下进行的膝关节和髋关节置换手术的结果。。

'We have found that robotic assistance leads to improved implant positioning, alignment and ligament balance, which enable us to better replicate the patient's natural anatomy,' said David J. Mayman, MD, chief of the Adult Reconstruction and Joint Replacement Service at HSS. 'With our vast registry of patient data and strong commitment to research, HSS is in a unique position to continue leading the evolution of robotic assistance in the operating room.'.

HSS成人重建和关节置换服务负责人David J.Mayman医学博士说：“我们发现机器人辅助可以改善植入物的定位，对齐和韧带平衡，从而使我们能够更好地复制患者的自然解剖结构。”。“凭借我们庞大的患者数据登记册和对研究的坚定承诺，HSS在继续领导手术室机器人辅助的发展方面处于独特的地位。”。

The first study found that the use of a surgical robot during total knee replacement surgery reduced the need for manipulation under anesthesia (MUA), an outpatient procedure that may be prescribed when physical therapy (PT) after surgery becomes too painful for the patient due to joint stiffness caused by scar tissue.

第一项研究发现，在全膝关节置换手术中使用手术机器人减少了麻醉下操作（MUA）的需要，这是一种门诊手术，当手术后的物理治疗（PT）由于疤痕组织引起的关节僵硬而对患者来说太痛苦时，可能会开出处方。

During the course of care, approximately 3.5% of knee replacement patients undergo MUA, according to Seth A. Jerabek, MD, hip and knee surgeon at HSS and co-author of this study, typically within 90 days of their surgery. After MUA, patients are typically better able to participate in PT and progress in their recovery..

根据HSS髋关节和膝关节外科医生兼本研究合著者Seth A.Jerabek医学博士的说法，在护理过程中，大约3.5%的膝关节置换患者通常在手术后90天内接受MUA。MUA后，患者通常能够更好地参与PT并在康复中取得进展。。

Investigators at HSS set out to determine if the use of computer navigation or robotic-arm assistance during surgery reduced the need for MUA. Previous studies have shown that the use of either tool leads to a more precise knee replacement.

HSS的调查人员着手确定在手术过程中使用计算机导航或机器人手臂辅助是否减少了对MUA的需求。先前的研究表明，使用任何一种工具都会导致更精确的膝关节置换术。

The HSS researchers conducted a retrospective chart review of 21,893 knee replacement surgeries performed between April 2008 and December 2022. They found that the use of the robotic arm or computer navigation led to a significant decrease in the number of patients who needed MUA after surgery (2.7% of patients with robotic-assisted surgery; 2.8% of patients whose surgery was performed with computer navigation; 3.7% of patients whose surgery was performed without either technology)..

HSS研究人员对2008年4月至2022年12月期间进行的21893例膝关节置换手术进行了回顾性图表审查。他们发现，使用机器人手臂或计算机导航导致手术后需要MUA的患者数量显着减少（2.7%的机器人辅助手术患者；2.8%的计算机导航手术患者；3.7%的手术患者没有任何一种技术）。。

'These results highlight the potential benefits of incorporating technological advancements into knee replacement surgery, offering improved outcomes and reducing the need for additional interventions such as MUA,' Dr. Jerabek said.

Jerabek博士说：“这些结果突显了将技术进步纳入膝关节置换手术的潜在好处，可以改善结果，减少对MUA等其他干预措施的需求。”。

The second study compared short-term outcomes of the anterior versus the posterior approach in robotic-assisted total hip replacement (THR) surgery. 'There is no consensus on which approach has a lower risk of postoperative complications,' said Elizabeth B.  Gausden, MD, MPH, a hip and knee surgeon at HSS and principal investigator of the study.

第二项研究比较了机器人辅助全髋关节置换术（THR）手术中前后入路的短期结果。”HSS髋关节和膝关节外科医生、该研究的首席研究员、医学博士伊丽莎白·高斯登（ElizabethB.Gausden）说，对于哪种方法术后并发症的风险较低，目前还没有达成共识。

'This can often lead to confusion on the part of the patient as to which approach may be best for them. Our objective was to compare rates of dislocation, re-operation, revision and patient-reported outcome measures of each approach performed with robotic assistance.'.

“这通常会导致患者对哪种方法最适合他们产生困惑。我们的目标是比较机器人辅助下每种方法的脱位率，再次手术率，翻修率和患者报告的结局指标。”。

Dr. Gausden and colleagues identified 2,040 consecutive robotic-assisted THRs for osteoarthritis in the HSS patient registry between 2017 and 2020. A total of 497 hip replacements were performed using the anterior approach; 1,542 were performed with the posterior approach.

Gausden博士及其同事在2017年至2020年间，在HSS患者登记处确定了2040例连续机器人辅助THR治疗骨关节炎。使用前路手术共进行了497次髋关节置换术；1542例采用后路手术。

At mean follow-up of 18 months, the researchers found no difference in the rate of dislocation, re-operation or revision surgery between the two approaches. At early follow-up of six weeks, the anterior approach was associated with a somewhat faster functional recovery. By 3 months following the THA, there were no longer significant differences between patients who had different approaches. 'The take-home message is that hip replacement has excellent outcomes with each respective approach when performed by surgeons with extensive experience in that approach,' Dr.

在平均18个月的随访中，研究人员发现两种方法在脱位率、再次手术率或翻修手术率方面没有差异。在六周的早期随访中，前路手术与更快的功能恢复相关。全髋关节置换术后3个月，采用不同方法的患者之间不再存在显着差异。“带回家的信息是，髋关节置换术在每种方法上都有很好的效果，当外科医生在这种方法上有丰富的经验时，”Dr。

Gausden said. 'While the goal of the study was not to compare robotic THA to manual THA, it is likely that the very low incidence of instability or dislocation overall can be attributed to the use of robotic technology for planning and execution.'.

高斯登说虽然这项研究的目的不是将机器人THA与手动THA进行比较，但总体上不稳定或脱位的发生率很可能是由于使用机器人技术进行规划和执行。”。

'As the use of robotic assistance in joint replacement surgery becomes more common, future studies should evaluate outcomes over longer periods of time,' concluded Dr. Mayman. 'As a leader in the use of this technology, HSS continues to study various robotic systems to acquire the data needed to provide the evidence-based care that will benefit our patients.'  .

“随着机器人辅助关节置换手术的使用越来越普遍，未来的研究应该在更长的时间内评估结果，”梅曼博士总结道作为这项技术使用的领导者，HSS继续研究各种机器人系统，以获取提供循证护理所需的数据，从而使患者受益。”。

References:

参考文献：

Robotic-assisted Total Knee Arthroplasty Is Associated with Decreased Manipulation under Anesthesia Compared to Manual ApproachAuthors: Cale Pagan; David J. Mayman, MD; Douglas E. Padgett, MD; Jonathan M. Vigdorchik, MD; Peter K. Sculco, MD; Seth A. Jerabek, MD; Theofilos Karasavvidis, MD (HSS).Program Number: P153 – February 14, 2024.

与手动方法相比，机器人辅助全膝关节置换术与麻醉下操作减少有关作者：Cale Pagan；David J.Mayman，医学博士；医学博士道格拉斯·E·帕吉特；乔纳森·维格多奇克（JonathanM.Vigdorchik），医学博士；医学博士Peter K.Sculco；医学博士Seth A.Jerabek；Theofilos Karasavidis，医学博士（HSS）。项目编号：P153–2024年2月14日。

Comparison of Short-Term Outcomes Between Direct Anterior and Posterolateral Approach in Robotic-Assisted Total Hip ArthroplastyAuthors: Nikhil Vasireddi, MHA (Case Western); Sonia Chandi, MD; Colin Neitzke; Agnes Cororaton, MS; Jason L. Blevins, MD; Jonathan M. Vigdorchik, MD; Alexander S. McLawhorn, MD, MBA; Elizabeth B.

机器人辅助全髋关节置换术中直接前后外侧入路的短期结果比较作者：Nikhil Vasireddi，MHA（Case Western）；医学博士Sonia Chandi；科林·奈茨克；Agnes Cororaton，MS；医学博士Jason L.Blevins；乔纳森·维格多奇克（JonathanM.Vigdorchik），医学博士；Alexander S.McLawhorn，医学博士，MBA；伊丽莎白B。

Gausden, MD, MPH (HSS).Program Number: e076 – February 12, 2024.

医学博士Gausden，公共卫生硕士（HSS）。项目编号：e076–2024年2月12日。

About HSSHSS is the world's leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the 14th consecutive year), No. 2 in rheumatology by U.S. News & World Report (2023-2024), and the best pediatric orthopedic hospital in NY, NJ and CT by U.S.

关于HSSHSS是世界领先的学术医学中心，专注于肌肉骨骼健康。其核心是特殊外科医院，在全国骨科排名第一（连续第14年），在风湿病方面排名第二（2023-2024年），在纽约、新泽西和CT方面排名第一（美国）。

News & World Report 'Best Children's Hospitals' list (2023-2024). In a survey of medical professionals in more than 20 countries by Newsweek, HSS is ranked world #1 in orthopedics for a fourth consecutive year (2023). Founded in 1863, the Hospital has the lowest readmission rates in the nation for orthopedics, and among the lowest infection and complication rates.

新闻与世界报道“最佳儿童医院”名单（2023-2024）。《新闻周刊》对20多个国家的医疗专业人员进行的一项调查显示，HSS连续第四年（2023年）在骨科领域排名世界第一。该医院成立于1863年，是全国骨科再入院率最低的医院，也是感染率和并发症发生率最低的医院之一。

HSS was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center five consecutive times. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State, as well as in Florida.

HSS是纽约州第一家连续五次获得美国护士资格认证中心对其卓越护理服务的磁铁认可。HSS是威尔·康奈尔医学院（Weill Cornell Medical College）的附属机构，在纽约市设有主校区，在新泽西州、康涅狄格州、纽约州长岛和韦斯特切斯特县以及佛罗里达州设有设施。

In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. In addition, more than 200 HSS clinical investigators are working to improve patient outcomes through better ways to prevent, diagnose, and treat orthopedic, rheumatic and musculoskeletal diseases.

除了患者护理，HSS在研究、创新和教育领域处于领先地位。HSS研究所由20个实验室和300名工作人员组成，致力于通过预防退化、组织修复和组织再生来促进肌肉骨骼健康。此外，200多名HSS临床研究人员正在通过更好的方法预防、诊断和治疗骨科、风湿性和肌肉骨骼疾病，努力改善患者的预后。

The HSS Innovation Institute works to realize the potential of new drugs, therapeutics and devices. The HSS Education Institute is a trusted leader in advancing musculoskeletal knowledge and research.

HSS创新研究所致力于挖掘新药、治疗方法和设备的潜力。HSS教育学院是推进肌肉骨骼知识和研究的可靠领导者。

SOURCE Hospital for Special Surgery

特殊外科来源医院