Comparação das complicações perioperatórias em artroplastia total de joelho: Abordagem robótica versus convencional – uma revisão da literatura

Autores

DOI:

https://doi.org/10.33448/rsd-v13i9.46748

Palavras-chave:

Artroplastia do joelho; Procedimentos cirúrgicos robóticos; Joelho.

Resumo

As doenças osteomusculares afetam negativamente o sistema musculoesquelético, causando dor e limitação de movimento, assim como danos na cartilagem devido a traumas mecânicos, obesidade e movimentos excessivos, levando a um ciclo inflamatório que compromete a articulação. Este estudo objetiva avaliar as complicações dos procedimentos cirúrgicos robótico e tradicional na ATJ. O desenho do estudo foi feito na forma de uma revisão integrativa da literatura. Revisaram-se as complicações intraoperatórias associadas à ATJ e ATJR, analisando 32 artigos de 2018 a 2024. A ATJ convencional apresenta complicações como hipotensão, atelectasias, trombose venosa profunda (TVP) e dor pós-operatória, com uma taxa de insatisfação de aproximadamente 20%. A ATJR, apesar de maior tempo de operação, mostra menor variação na angulação da prótese e redução na necessidade de transfusões sanguíneas. No entanto, a ATJR tem custos mais altos e maior risco de infecções. O uso de torniquete durante a ATJ está associado a complicações como aumento de dor e risco de trombose, enquanto o ácido tranexâmico (TXA) demonstra eficácia na redução da perda sanguínea e necessidade de transfusões, sem impacto negativo significativo na dor ou amplitude de movimento. A infiltração periarticular (PAI) é mais eficaz na redução da dor pós-operatória comparada ao bloqueio do canal do adutor (ACB). Conclusivamente, a ATJR oferece vantagens na precisão e estabilidade da prótese, mas com desafios como maior custo e tempo de operação, devendo a escolha do método considerar as especificidades e riscos de cada abordagem.

Referências

Alexandersson, M., Wang, E. Y., & Eriksson, S. (2019). A small difference in recovery between total knee arthroplasty with and without tourniquet use the first 3 months after surgery: a randomized controlled study. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA, 27(4), 1035–1042. https://doi.org/10.1007/s00167-018-5196-8

Cao, Q., Wu, Q., Liu, Y., He, Z., Cong, Y., Meng, J., Zhao, J., & Bao, N. (2022). Effects of Tourniquet Application on Faster Recovery after Surgery and Ischemia-Reperfusion Post-Total Knee Arthroplasty, Cementation through Closure versus Full-Course and Nontourniquet Group. The journal of knee surgery, 35(14), 1577–1586. https://doi.org/10.1055/s-0041-1728814

Cheng, K. Y., Feng, B., Peng, H. M., Bian, Y. Y., Zhang, L. J., Han, C., Qiu, G. X., & Weng, X. (2020). The analgesic efficacy and safety of peri-articular injection versus intra-articular injection in one-stage bilateral total knee arthroplasty: a randomized controlled trial. BMC anesthesiology, 20(1), 2. https://doi.org/10.1186/s12871-019-0922-4

Chun, L., Michael Tim-Yun Ong, Chau, W.-W., Jonathan Patrick Ng, Griffith, J. F., & Kevin Ki-Wai Ho. (2022). Avulsion Fracture of Bicruciate Ligament and Patellar Tendon in Bicruciate-Retaining Total Knee Arthroplasty. Arthroplasty Today, 16, 57–62. https://doi.org/10.1016/j.artd.2022.04.013

Danoff, J. R., Heimroth, J., Willinger, M., Trout, S., & Sodhi, N. (2023). Surgical Technique: Robotic-Assisted 1.5-Stage Exchange Total Knee Arthroplasty for Periprosthetic Joint Infection. Arthroplasty Today, 21(2352-3441), 101126–101126. https://doi.org/10.1016/j.artd.2023.101126

Deckey, D. G., Verhey, J. T., Rosenow, C. S., Doan, M. K., McQuivey, K. S., Joseph, A. M., Schwartz, A. J., Clarke, H. D., & Bingham, J. S. (2022). Robotic-Assisted Total Knee Arthroplasty Allows for Trainee Involvement and Teaching Without Lengthening Operative Time. The Journal of Arthroplasty, 37(6S), S201–S206. https://doi.org/10.1016/j.arth.2021.12.030

He, R., Sun, M., Xiong, R., Yang, J., Guo, L., & Yang, L. (2023). Semiactive robotic-arm system versus patient-specific instrumentation in primary total knee arthroplasty: Efficacy and accuracy. Asian Journal of Surgery, 46(2), 742–750. https://doi.org/10.1016/j.asjsur.2022.06.151

Held, M. B., Grosso, M. J., Gazgalis, A., Sarpong, N. O., Boddapati, V., Neuwirth, A., & Geller, J. A. (2021). Improved Compartment Balancing Using Robot-Assisted Total Knee Arthroplasty. Arthroplasty Today, 7, 130–134. https://doi.org/10.1016/j.artd.2020.12.022

Karampinas, P. K., Megaloikonomos, P. D., Lampropoulou-Adamidou, K., Papadelis, E. G., Mavrogenis, A. F., Vlamis, J. A., & Pneumaticos, S. G. (2019). Similar thromboprophylaxis with rivaroxaban and low molecular weight heparin but fewer hemorrhagic complications with combined intra-articular and intravenous tranexamic acid in total knee arthroplasty. European journal of orthopaedic surgery & traumatology: orthopedie traumatologie, 29(2), 455–460. https://doi.org/10.1007/s00590-018-2307-7

Kulkarni, M. M., Dadheech, A. N., Wakankar, H. M., Ganjewar, N. V., Hedgire, S. S., & Pandit, H. G. (2019). Randomized Prospective Comparative Study of Adductor Canal Block vs Periarticular Infiltration on Early Functional Outcome After Unilateral Total Knee Arthroplasty. The Journal of arthroplasty, 34(10), 2360–2364. https://doi.org/10.1016/j.arth.2019.05.049

Lai, Y., Xu, H., Su, Q., Wan, X., Yuan, M., & Zhou, Z. (2022). Effect of tourniquet use on blood loss, pain, functional recovery, and complications in robot-assisted total knee arthroplasty: a prospective, double-blinded, randomized controlled trial. Journal of Orthopaedic Surgery and Research, 17(1). https://doi.org/10.1186/s13018-022-02992-y

Lin, W., Niu, J., Dai, Y., Zhang, H., Zhu, J., & Wang, F. (2020). A surgical reduction technique for posterior cruciate ligament avulsion fracture in total knee arthroplasty: a comparison study. Journal of orthopaedic surgery and research, 15(1), 295. https://doi.org/10.1186/s13018-020-01810-7

Loeser, R. F. (2023). Pathogenesis of osteoarthritis. https://www.uptodate.com/contents/pathogenesis-of-osteoarthritis

Lu, C., Song, M., Chen, J., Li, C., Lin, W., Ye, G., Wu, G., Li, A., Cai, Y., Wu, H., Liu, W., & Xu, X. (2020). Does tourniquet use affect the periprosthetic bone cement penetration in total knee arthroplasty? A meta-analysis. Journal of orthopaedic surgery and research, 15(1), 602. https://doi.org/10.1186/s13018-020-02106-6

Luo, Y., Zhao, X., Releken, Y., Yang, Z., Pei, F., & Kang, P. (2020). Hemostatic and Anti-Inflammatory Effects of Carbazochrome Sodium Sulfonate in Patients Undergoing Total Knee Arthroplasty: A Randomized Controlled Trial. The Journal of arthroplasty, 35(1), 61–68. https://doi.org/10.1016/j.arth.2019.07.045

Naziri, Q., Burekhovich, S. A., Mixa, P. J., Pivec, R., Newman, J. M., Shah, N. V., Patel, P. D., & Sastry, A. (2019). The trends in robotic-assisted knee arthroplasty: A statewide database study. Journal of Orthopaedics, 16(3), 298–301. https://doi.org/10.1016/j.jor.2019.04.020

Pinsornsak, P., Pinitchanon, P., & Boontanapibul, K. (2021). Effect of Different Tourniquet Pressure on Postoperative Pain and Complications After Total Knee Arthroplasty: A Prospective, Randomized Controlled Trial. The Journal of arthroplasty, 36(5), 1638–1644. https://doi.org/10.1016/j.arth.2020.12.049

Raddaoui, K., Khedhri, W., Zoghlami, K., Radhouani, M., Trigui, E., & Kaabachi, O. (2019). Perioperative morbidity in total knee arthroplasty. The Pan African medical journal, 33, 233. https://doi.org/10.11604/pamj.2019.33.233.19095

Smith, A. F., Usmani, R. H., Wilson, K. D., Smith, L. S., & Malkani, A. L. (2021). Effect of Tourniquet Use on Patient Outcomes After Cementless Total Knee Arthroplasty: A Randomized Controlled Trial. The Journal of Arthroplasty, 36(7), 2331–2334. https://doi.org/10.1016/j.arth.2021.01.053

Soares, C. O., Pereira, B. F., Gomes, M. V. P., Marcondes, L. P., Gomes, F. de C., & Neto, J. S. de M. -. (2019). Preventive Factors against work-related Musculoskeletal disorders: Narrative Review. Revista Brasileira de Medicina Do Trabalho, 17(3), 415–430. https://doi.org/10.5327/z1679443520190360

Sousa, A. S. de; Oliveira, G. S. de; Alves, L. H. (2021) A pesquisa bibliográfica: princípios e fundamentos. Cadernos da FUCAMP, 20(43).

Stulberg, B. N., Zadzilka, J. D., Kreuzer, S., Yair Kissin, Liebelt, R. A., Long, W. J., & Campanelli, V. (2021). Safe and effective use of active robotics for TKA: Early results of a multicenter study. Journal of Orthopaedics, 26, 119–125. https://doi.org/10.1016/j.jor.2021.07.001

Tang, Y., Wen, Y., Li, W., Li, H., Yang, Y., & Liu, Y. (2019). The efficacy and safety of multiple doses of oral tranexamic acid on blood loss, inflammatory and fibrinolysis response following total knee arthroplasty: A randomized controlled trial. International journal of surgery (London, England), 65, 45–51. https://doi.org/10.1016/j.ijsu.2019.03.011

Taylor, S. K., Sephian, A., & Clader, T. (2020). Intraoperative tibial plateau fracture during bone preparation in a cruciate retaining primary total knee arthroplasty. BMJ case reports, 13(9), e233826. https://doi.org/10.1136/bcr-2019-233826

Tompkins, G. S., Sypher, K. S., Li, H.-F., Griffin, T. M., & Duwelius, P. J. (2021). Robotic Versus Manual Total Knee Arthroplasty in High Volume Surgeons: A Comparison of Cost and Quality Metrics. The Journal of Arthroplasty. https://doi.org/10.1016/j.arth.2021.12.018

Volpin, A., Maden, C., & Konan, S. (2020). New Advances in Robotic Surgery in Hip and Knee Replacement. Elsevier EBooks, 397–410. https://doi.org/10.1016/b978-0-12-814245-5.00023-2

Wang, H. Y., Wang, L., Luo, Z. Y., Wang, D., Tang, X., Zhou, Z. K., & Pei, F. X. (2019). Intravenous and subsequent long-term oral tranexamic acid in enhanced-recovery primary total knee arthroplasty without the application of a tourniquet: a randomized placebo-controlled trial. BMC musculoskeletal disorders, 20(1), 478. https://doi.org/10.1186/s12891-019-2885-5

Wang, H. Y., Yuan, M. C., Pei, F. X., Zhou, Z. K., & Liao, R. (2020). Finding the optimal control level of intraoperative blood pressure in no tourniquet primary total knee arthroplasty combine with tranexamic acid: a retrospective cohort study which supports the enhanced recovery strategy. Journal of orthopaedic surgery and research, 15(1), 350. https://doi.org/10.1186/s13018-020-01887-0

Wang, J. C., Piple, A. S., Hill, W. J., Chen, M. S., Gettleman, B. S., Richardson, M., Heckmann, N. D., & Christ, A. B. (2022). Computer-Navigated and Robotic-Assisted Total Knee Arthroplasty: Increasing in Popularity Without Increasing Complications. The Journal of Arthroplasty, 37(12), 2358–2364. https://doi.org/10.1016/j.arth.2022.06.014

Wang, Y., & Zhou, A. (2020). A new improvement: subperiosteal cocktail application to effectively reduce pain and blood loss after total knee arthroplasty. Journal of orthopaedic surgery and research, 15(1), 33. https://doi.org/10.1186/s13018-020-1563-5

Xu, H., Xie, J., Yang, J., Huang, Z., Wang, D., & Pei, F. (2023). Synergistic Effect of a Prolonged Combination Course of Tranexamic Acid and Dexamethasone Involving High Initial Doses in Total Knee Arthroplasty: A Randomized Controlled Trial. The journal of knee surgery, 36(5), 515–523. https://doi.org/10.1055/s-0041-1739197

Xu, J., Li, L., Fu, J., Xu, C., Ni, M., Chai, W., Hao, L., Zhang, G., & Chen, J. (2022). Early Clinical and Radiographic Outcomes of Robot-Assisted Versus Conventional Manual Total Knee Arthroplasty: A Randomized Controlled Study. Orthopaedic Surgery, 14(9), 1972–1980. https://doi.org/10.1111/os.13323

Yuan, M., Shi, X., Su, Q., Wan, X., & Zhou, Z. (2021). A prospective randomized controlled trial on the short-term effectiveness of domestic robot-assisted total knee arthroplasty. Chinese Journal of Reparative and Reconstructive Surgery, 35(10). https://doi.org/10.7507/1002-1892.202106047

Zhang, Y. M., Yang, B., Sun, X. D., & Zhang, Z. (2019). Combined intravenous and intra-articular tranexamic acid administration in total knee arthroplasty for preventing blood loss and hyperfibrinolysis: A randomized controlled trial. Medicine, 98(7), e14458. https://doi.org/10.1097/MD.0000000000014458

Downloads

Publicado

14/09/2024

Como Citar

OLIVEIRA FILHO, O. L. de .; VALLE, A. L. .; BORBA, P. H. C. .; FABRICIO, M. C. F. .; PEREIRA, R. C. .; RIBEIRO, D. F. .; CONFESSOR, M. V. A. . Comparação das complicações perioperatórias em artroplastia total de joelho: Abordagem robótica versus convencional – uma revisão da literatura. Research, Society and Development, [S. l.], v. 13, n. 9, p. e3813946748, 2024. DOI: 10.33448/rsd-v13i9.46748. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/46748. Acesso em: 27 set. 2024.

Edição

Seção

Ciências da Saúde