Complications and downsides of the robotic total knee arthroplasty: a systematic review,Knee Surgery, Sports Traumatology, Arthroscopy

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Complications and downsides of the robotic total knee arthroplasty: a systematic review
Knee Surgery, Sports Traumatology, Arthroscopy ( IF 3.3 ) Pub Date : 2022-06-18 , DOI: 10.1007/s00167-022-07031-1
Christian Nogalo _{1,

2} , Amit Meena _{1,

2} , Elisabeth Abermann _{1,

2} , Christian Fink _{1,

2}

Affiliation

Purpose

The purpose of this systematic review is to describe the complications and downsides of robotic systems in total knee arthroplasty (TKA).

Methods

A comprehensive search according to the PRISMA guidelines was performed across PubMed, MEDLINE, Cochrane Central Register of Controlled Trials, Scopus, and Google Scholar from inception until December 2021. All articles of any study design directly reporting on complications and downsides of the robotic system in TKA were considered for inclusion. Risk of bias assessment was performed for all included studies using the Cochrane risk of bias and MINORS score.

Results

A total of 21 studies were included, consisting of 4 randomized controlled trials, 7 prospective studies and 10 retrospective studies. Complications of the robotic system were pin-hole fracture, pin-related infection, iatrogenic soft tissue and bony injury, and excessive blood loss. While, downsides were longer operative duration, higher intraoperative cost, learning curve and aborting a robotic TKA due to different reasons. Iatrogenic injuries were more common in the active robotic system and abortion of the robotic TKA was reported only with active robotic TKA.

Conclusion

Robotic TKA is associated with certain advantages and disadvantages. Therefore, surgeons need to be familiar with the system to use it effectively. Widespread adoption of the robotic system should always be evidence-based.

Level of evidence

IV.

中文翻译：

机器人全膝关节置换术的并发症和缺点：系统回顾

目的

本系统评价的目的是描述机器人系统在全膝关节置换术 (TKA) 中的并发症和缺点。

方法

从一开始到 2021 年 12 月，我们根据 PRISMA 指南在 PubMed、MEDLINE、Cochrane 对照试验中央注册中心、Scopus 和 Google Scholar 中进行了全面搜索。任何研究设计的所有文章都直接报告机器人系统的并发症和缺点TKA 被考虑纳入。使用 Cochrane 偏倚风险和 MINORS 评分对所有纳入的研究进行偏倚风险评估。

结果

共纳入 21 项研究，包括 4 项随机对照试验、7 项前瞻性研究和 10 项回顾性研究。机器人系统的并发症是针孔骨折、针相关感染、医源性软组织和骨损伤以及失血过多。同时，缺点是手术时间更长、术中成本更高、学习曲线和由于不同原因而中止机器人 TKA。医源性损伤在主动式机器人系统中更为常见，并且仅在主动式机器人 TKA 中报告了机器人 TKA 的流产。