Comparison of serum inflammatory indicators and radiographic results in MAKO robotic-assisted versus conventional total knee arthroplasty for knee osteoarthritis: a ... View Full Text


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Article Info

DATE

2022-05-04

AUTHORS

Jia-Zheng Xu, Liang-Liang Li, Jun Fu, Chi Xu, Guo-Qiang Zhang, Wei Chai, Li-Bo Hao, Xiang Li, Ji-Ying Chen

ABSTRACT

BackgroundThe purpose of this study was to compare the serum inflammatory indicators and radiographic results of conventional manual total knee arthroplasty (CM-TKA) with those of MAKO-robotic assisted total knee arthroplasty (MA-TKA).MethodsWe retrospectively analysed 65 patients with knee osteoarthritis who underwent unilateral TKA from December 2020 to November 2021 in our department, which included 34 patients who underwent MA-TKA and 31 patients who underwent CM-TKA. The tourniquet time and estimated blood loss (EBL) were compared between the two groups. Knee function was evaluated using range of motion (ROM), functional score and pain score. Leukocytes, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6), creatine kinase (CK), and neutrophil-to-lymphocyte ratio (NLR) were recorded at 3 time points (preoperative, and on the first and third postoperative days). The hip-knee-ankle angle (HKA) and the femoral and tibial component angles in the coronal and sagittal planes were used for postoperative radiographic evaluation.ResultsThe postoperative MA-TKA group had less EBL (496.9 ± 257.8 vs. 773.0 ± 301.3 ml, p < 0.001). There was no significant difference in knee function scores at 6 weeks postoperatively (p > 0.05). IL-6 levels were significantly lower in the MA-TKA group on the 1st postoperative day (11.4 (5.2, 21.0) vs. 24.6 (86.3, 170.8), p = 0.031). This difference in inflammatory indices became more pronounced at 72 hours after the operation because CRP, ESR, IL-6, and CK values were significantly lower in the MA-TKA group on the 3rd postoperative day (72 h) (p < 0.05). Postoperative radiographic examinations performed 2 days after the MA-TKA group suggested that only 2 cases of HKA had outlier values, which was remarkably better than the 12 cases found in the CM-TKA group (5.9% vs. 38.7%, p < 0.001). The frontal femoral component was significantly closer to the expected value of 90° in the MA-TKA group (90.9 (90.5, 92.3) vs. 92.4 (91.3, 93.7), p = 0.031). The remaining imaging evaluation parameters were not significantly different between the two groups (p > 0.05).ConclusionsIn Chinese patients with OA, there was a milder systemic inflammatory response in the early postoperative period after MA-TKA compared to that of CM-TKA, as well as better radiographic outcomes. However, the tourniquet time was prolonged, and no advantages were observed in terms of functional score or pain score in the short-term follow-up. More... »

PAGES

418

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12891-022-05373-y

DOI

http://dx.doi.org/10.1186/s12891-022-05373-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1147615240

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/35509075


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23 schema:description BackgroundThe purpose of this study was to compare the serum inflammatory indicators and radiographic results of conventional manual total knee arthroplasty (CM-TKA) with those of MAKO-robotic assisted total knee arthroplasty (MA-TKA).MethodsWe retrospectively analysed 65 patients with knee osteoarthritis who underwent unilateral TKA from December 2020 to November 2021 in our department, which included 34 patients who underwent MA-TKA and 31 patients who underwent CM-TKA. The tourniquet time and estimated blood loss (EBL) were compared between the two groups. Knee function was evaluated using range of motion (ROM), functional score and pain score. Leukocytes, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6), creatine kinase (CK), and neutrophil-to-lymphocyte ratio (NLR) were recorded at 3 time points (preoperative, and on the first and third postoperative days). The hip-knee-ankle angle (HKA) and the femoral and tibial component angles in the coronal and sagittal planes were used for postoperative radiographic evaluation.ResultsThe postoperative MA-TKA group had less EBL (496.9 ± 257.8 vs. 773.0 ± 301.3 ml, p < 0.001). There was no significant difference in knee function scores at 6 weeks postoperatively (p > 0.05). IL-6 levels were significantly lower in the MA-TKA group on the 1st postoperative day (11.4 (5.2, 21.0) vs. 24.6 (86.3, 170.8), p = 0.031). This difference in inflammatory indices became more pronounced at 72 hours after the operation because CRP, ESR, IL-6, and CK values were significantly lower in the MA-TKA group on the 3rd postoperative day (72 h) (p < 0.05). Postoperative radiographic examinations performed 2 days after the MA-TKA group suggested that only 2 cases of HKA had outlier values, which was remarkably better than the 12 cases found in the CM-TKA group (5.9% vs. 38.7%, p < 0.001). The frontal femoral component was significantly closer to the expected value of 90° in the MA-TKA group (90.9 (90.5, 92.3) vs. 92.4 (91.3, 93.7), p = 0.031). The remaining imaging evaluation parameters were not significantly different between the two groups (p > 0.05).ConclusionsIn Chinese patients with OA, there was a milder systemic inflammatory response in the early postoperative period after MA-TKA compared to that of CM-TKA, as well as better radiographic outcomes. However, the tourniquet time was prolonged, and no advantages were observed in terms of functional score or pain score in the short-term follow-up.
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30 schema:keywords C-reactive protein
31 CK values
32 Chinese patients
33 Department
34 EBL
35 HKA
36 IL-6 levels
37 MA-TKA
38 MethodsWe
39 OA
40 TKA
41 advantages
42 angle
43 ankle angle
44 arthroplasty
45 blood loss
46 cases
47 comparison
48 component angle
49 components
50 conventional total knee arthroplasty
51 creatine kinase
52 days
53 differences
54 early postoperative period
55 erythrocyte sedimentation rate
56 evaluation
57 evaluation parameters
58 examination
59 femoral component
60 function
61 function scores
62 functional scores
63 good radiographic outcome
64 group
65 hours
66 index
67 indicators
68 inflammatory index
69 inflammatory indicators
70 inflammatory response
71 interleukin-6
72 kinase
73 knee arthroplasty
74 knee function
75 knee function score
76 knee osteoarthritis
77 less EBL
78 leukocytes
79 levels
80 loss
81 lymphocyte ratio
82 mako
83 manual total knee arthroplasty
84 motion
85 operation
86 osteoarthritis
87 outcomes
88 outlier values
89 pain scores
90 parameters
91 patients
92 period
93 plane
94 point
95 postoperative day
96 postoperative period
97 postoperative radiographic evaluation
98 postoperative radiographic examination
99 protein
100 purpose
101 radiographic evaluation
102 radiographic examination
103 radiographic outcomes
104 radiographic results
105 range
106 range of motion
107 rate
108 ratio
109 response
110 results
111 retrospective study
112 sagittal plane
113 scores
114 sedimentation rate
115 serum inflammatory indicators
116 significant differences
117 study
118 systemic inflammatory response
119 terms
120 tibial component angle
121 time
122 time points
123 total knee arthroplasty
124 tourniquet time
125 unilateral TKA
126 values
127 weeks
128 schema:name Comparison of serum inflammatory indicators and radiographic results in MAKO robotic-assisted versus conventional total knee arthroplasty for knee osteoarthritis: a retrospective study of Chinese patients
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