机器人辅助与传统全膝关节置换术的比较：一项系统评价与Meta分析。
完整摘要 · 中文译文
引言：机器人辅助全膝关节置换术（RTKA）是传统全膝关节置换术（CTKA）的一种新兴替代方法，其有效性尚不明确。本系统评价与荟萃分析旨在比较RTKA与CTKA的临床和影像学结果。 方法：共纳入52项研究（随机对照试验和观察性队列）。比较的结局包括力线（髋膝踝角、股骨/胫骨组件角度）、患者报告结局指标（PROMs）、手术时间、住院时间（LOS）、失血量和并发症。采用随机效应模型合并数据，并使用R通过I²统计量评估异质性。 结果：RTKA在组件对线方面表现出更高的准确性，大多数PROMs显示出极小差异。RTKA的手术时间较长，但住院时间较短。RTKA失血量较低。炎症标志物和翻修率方面存在少数不一致的发现。 结论：RTKA改善机械力线并减少离群值，在PROMs和恢复指标方面具有适度的短期优势。长期临床获益需要更多采用标准化结局指标的高质量研究。 试验注册：本系统评价与荟萃分析已在PROSPERO注册（注册号：CRD42023410154）。
完整摘要 · 英文原文
INTRODUCTION: Robotic-assisted total knee arthroplasty (RTKA) is an emerging alternative to conventional total knee arthroplasty (CTKA) with uncertain effectiveness. This systematic and meta-analysis aims to compare clinical and radiological outcomes between RTKA and CTKA. METHODS: 52 studies were included (randomised controlled trials and observational cohorts). Outcomes compared were alignment (Hip-Knee-Ankle angle, femoral/tibial component angles), Patient Reported Outcome Measures (PROMs), operative time, length of stay (LOS), blood loss, and complications. Data were pooled using random-effect models, with heterogeneity assessed via I2 statistics using R. RESULTS: RTKA demonstrated superior accuracy in component alignment, and most PROMs showed minimal differences. Operative time was longer for RTKA, but hospital LOS was shorter. RTKA had lower blood loss. Inflammatory markers and revision rates showed few inconsistent findings. CONCLUSION: RTKA improves mechanical alignment and reduces outliers, with modest short-term advantages in PROMs and recovery metrics. Long-term clinical benefits necessitate further high-quality studies with standardised outcome measures. TRIAL REGISTRATION: This Systematic Review and Meta-Analysis was registered on PROSPERO (ID number: CRD42023410154).