W Wielkiej Brytanii rozpoczyna się krajowe badanie nad skutecznością nowych technologii w operacjach wymiany stawu kolanowego. Naukowcy chcą ustalić, która z dwóch technik – z wykorzystaniem maszyny lub manualna – ma lepszy wpływ na wyniki pacjentów i lepiej zmniejsza ból po endoprotezoplastyce.
Naukowcy planują porównać korzyści płynące z operacji wymiany stawu kolanowego przy użyciu maszyny z umiejętnościami i precyzją chirurga stosującego tradycyjne metody operacji. Badanie prowadzone jest przez University Hospitals Coventry and Warwickshire (UHCW) NHS Trust przy współpracy z Warwick Medical School na Uniwersytecie w Warwick oraz Royal Orthopaedic Hospital (ROH) w Birmingham.
Badanie o wartości 1,6 mln funtów
332 uczestników badania zostanie podzielonych na dwie grupy. Pacjenci z pierwszej grupy przejdą operację wymiany stawu kolanowego z zastosowaniem maszyny, natomiast w drugiej grupie chorzy zostaną zoperowani tradycyjną metodą. Dzięki równej liczbie uczestników w obu grupach możliwe będzie przeprowadzenie zrównoważonego i sprawiedliwego porównania technik chirurgicznych. Do badań zaproszeni zostaną pacjenci z sześciu szpitali NHS w Anglii i Szkocji. Randomizowane, kontrolowane badanie o wartości 1,6 mln funtów finansowane jest przez National Institute for Health Research (NIHR).
Uczestnicy badania rok po operacji wypełnią kwestionariusz oceniający proces powrotu do zdrowia. Wszyscy pacjenci otrzymają te same instrukcje dotyczące rehabilitacji i regeneracji po wymianie stawu kolanowego. Badacze obliczą m.in. utratę krwi w trakcie zabiegu, użyte środki przeciwbólowe i czas spędzony w szpitalu. Trzy, sześć i dwanaście miesięcy po zabiegu uczestnicy badania zostaną zapytani o to, jak bardzo zadowoleni są z efektu operacji, jaki jest ich ogólny stan zdrowia i czy mieli jakiekolwiek problemy po operacji wymiany stawu kolanowego. Naukowcy porównają również koszty obu metod operacji wymiany stawu kolanowego.
Dokładność i precyzja maszyny
Maszyna wykorzystywana operacji wymiany stawu kolanowego, za pomocą oprogramowania 3D, projektuje wirtualny obraz nogi pacjenta na podstawie badania tomograficznego. Dzięki temu chirurg może zaplanować optymalną resekcję kości, umiejscowienie i rozmiar implantu i ustawienia kończyny w oparciu o unikalny model anatomiczny kończyny pacjenta, a także ocenić strukturę kości czy nasilenie choroby. Dzięki dokładnemu przedoperacyjnemu zaplanowaniu resekcji kości ogranicza się u pacjenta uszkodzenia tkanek miękkich okołostawowych i urazy kości.
– Obecnie coraz częściej spotykamy się z wykorzystaniem robotów w chirurgii. Badanie to dotyczy tego, czy wykorzystanie robota daje lepsze wyniki u pacjentów poddawanych operacji wymiany stawu kolanowego – mówi prof. Andy Metcalfe z Uniwersytetu w Warwick, jeden z chirurgów, którzy będą prowadzili analizę.
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Systemy zrobotyzowane są coraz częściej wykorzystywane podczas operacji wymiany stawu kolanowego, ale chirurdzy nadal nie wiedzą, czy metoda, która jest niezwykle kosztowna, przynosi lepsze efekty od tradycyjnych technik. Jeżeli okaże się, że chirurgia wspomagana systemami robotycznymi spowoduje zmniejszenie liczby powikłań i krótszą hospitalizację, zdaniem naukowców wpłynie to również na zmniejszenie kosztów placówek medycznych.
Większość zabiegów wymiany stawu kolanowego przeprowadzonych metodą tradycyjną zmniejsza ból i niepełnosprawność spowodowaną ciężkim zapaleniem stawów. Jednak jedna na pięć osób jest niezadowolona z wyniku operacji lub odczuwa ból porównywalny do tego sprzed zabiegu. Dlatego autorzy badania podkreślają, że potrzebna jest porównawcza ocena efektywności operacji wymiany stawu kolanowego przeprowadzonej z użyciem maszyny lub metodą manualną.
Źródło: news-medical.net, NIHR
Przeczytaj także: Chirurdzy ICZMP zrekonstruowali pierś wykorzystując tkanki własne pacjentki
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