机器人辅助关节镜下重建前交叉韧带的疗效  

Efficacy of robot-assisted arthroscopic anterior cruciate ligament reconstruction

作　　者：张丽[1] 梁求真 赵赞栋 康鑫 田斌[1] 任博 张宪[1] 董补怀[2] 郑江[1] 张亮[1] Zhang Li;Liang Qiuzhen;Zhao Zandong;Kang Xin;Tian Bin;Ren Bo;Zhang Xian;Dong Buhuai;Zheng Jiang;Zhang Liang(Department of Sports Medicine Center,Honghui Hosptial,Xi′an Jiaotong University,Xi′an 710054,China;Department of Anesthesiology,Honghui Hosptial,Xi′an Jiaotong University,Xi′an 710054,China)

机构地区：[1]西安交通大学附属红会医院运动医学中心,西安710054 [2]西安交通大学附属红会医院麻醉科,西安710054

出　　处：《中华创伤杂志》2022年第2期142-148,共7页Chinese Journal of Trauma

摘　　要：目的比较机器人辅助关节镜下重建与单纯关节镜下重建前交叉韧带(ACL)的临床疗效。方法采用回顾性队列研究分析2020年1月至2020年9月西安交通大学附属红会医院收治的37例ACL撕裂患者的临床资料,其中男24例,女13例;年龄16~45岁[(30.7±9.8)岁]。17例在机器人辅助关节镜下行ACL重建(机器人组),20例在单纯关节镜下行ACL重建(单纯关节镜组)。比较两组手术时间、导针钻孔次数、骨道位点的准确性(骨道中心点距理想解剖点的距离)、围术期并发症情况。术前、术后4个月及末次随访时采用Lachman试验、KT-2000测量数值评估膝关节稳定情况,采用Lysholm评分、国际膝关节文献委员会(IKDC)评分及关节屈伸活动度评估膝关节功能恢复情况。结果患者均获随访12~18个月[(13.1±4.1)个月]。机器人组手术时间为(83.8±11.3)min,明显长于单纯关节镜组的(50.4±9.1)min(P<0.01)。机器人组导针钻孔次数为(2.2±0.5)次,较关节镜组的(2.5±0.4)次少(P<0.05)。机器人组骨道中心点距理想解剖点的距离为(1.3±0.3)mm,关节镜组为(1.4±0.3)mm,两组差异无统计学意义(P>0.05)。两组均未见围术期并发症。术前、术后4个月及末次随访时两组间Lachman试验、KT-2000测量数值、Lysholm评分、IKDC评分及关节屈伸活动度差异无统计学意义(P均>0.05);两组内术后4个月及末次随访时以上相关指标较术前显著改善(P均<0.01),术后4个月与末次随访时以上相关指标差异无统计学意义(P均>0.05)。结论机器人辅助关节镜下重建ACL较单纯关节镜下重建ACL手术时间稍长,但可一次性制备具有良好位点及方向的骨道,获得与单纯关节镜下重建ACL相似的关节稳定性及功能恢复。Objective To compare the clinical efficacy of robot-assisted and simple arthroscopic reconstruction of anterior cruciate ligament(ACL).Methods A retrospective cohort study was conducted to analyze the clinical data of 37 patients with ACL tear admitted to Honghui Hospital of Xi′an Jiaotong University from January 2020 to September 2020.There were 24 males and 13 females,aged 16-45 years[(30.7±9.8)years].A total of 17 patients were treated by robot-assisted ACL reconstruction(robot-assisted group),and 20 patients by simple arthroscopic ACL reconstruction(simple arthroscopy group).The operation time,number of guide wire drilling,positional accuracy of bone tunnel(distance between the central point of bone tunnel and ideal anatomical point)and perioperative complications were compared between the two groups.Knee stability was evaluated by Lachman test and KT-2000 measurement,and knee function by Lysholm score,International Knee Documentation Committee(IKDC)score and range of motion of joint flexion and extension before operation,at 4 months after operation and at the last follow-up.Results All patients were followed up for 12-18 months[(13.1±4.1)months].The operation time in robot-assisted group was(83.8±11.3)minutes,significantly longer than(50.4±9.1)minutes in simple arthroscopy group(P<0.01).The number of guide wire drilling in robot-assisted group was(2.2±0.5)times,less than(2.5±0.4)times in simple arthroscopy group(P<0.05).The distance between the central point of bone tunnel and ideal anatomical point was(1.3±0.3)mm in robot-assisted group,not significantly different from(1.4±0.3)mm in simple arthroscopy group(P>0.05).There were no perioperative complications in both groups.The two groups showed no significant differences in Lachman test,KT-2000 measurement,Lysholm score,IKDC score and range of motion of joint flexion and extension before operation,at 4 months after operation and at the last follow-up(all P>0.05).The above indices in both groups were significantly improved at 4 months after operation

关 键 词：前交叉韧带 机器人 外科手术 计算机辅助 软组织损伤 

分 类 号：R687.4[医药卫生—骨科学]