机器人辅助髓芯减压植骨治疗ARCOⅡ期股骨头坏死  

Robot-assisted core decompression and bone grafting for ARCO Ⅱ osteonecrosis of the femoral head

作　　者：李辉[1,2] 张堃[2] 郝阳泉[2] 冯磊[2] 杨治[2] 许鹏[2] 鲁超[2] Li Hui;Zhang Kun;Hao Yangquan;Feng Lei;Yang Zhi;Xu Peng;Lu Chao(Shaanxi University of Traditional Chinese Medicine,Xianyang 712000,Shaanxi Province,China;Honghui Hospital,Xi’an Jiaotong University,Xi’an 710000,Shaanxi Province,China)

机构地区：[1]陕西中医药大学,陕西省咸阳市712000 [2]西安交通大学附属红会医院,陕西省西安市710000

出　　处：《中国组织工程研究》2023年第4期547-551,共5页Chinese Journal of Tissue Engineering Research

基　　金：陕西省中医药管理局中西医结合临床协作创新项目(2020-ZXY-010),项目负责人:郝阳泉;陕西省科技厅项目(2021SF-250),项目负责人:杨治。

摘　　要：背景:髓芯减压植骨是ARCOⅡ期股骨头坏死的主要保髋术式之一,但传统手术方式存在透视时间长、出血量大等缺点。目的:分析机器人辅助下进行髓芯减压植骨术治疗ARCOⅡ期股骨头坏死的临床治疗特点,为股骨头坏死保髋治疗提供新思路。方法:回顾性分析2017年6月到2019年12月于西安交通大学附属红会医院骨坏死与关节重建科因股骨头坏死行髓芯减压植骨治疗的100例患者资料,其中骨科机器人导航辅助下髓芯减压植骨患者50例,男性36例,女性14例,年龄30-74(47.52±12.50)岁,设为机器人导航组;常规髓芯减压植骨患者50例,男性37例,女性13例,年龄28-77(50.68±13.60)岁,设为常规手术组;所有手术均为同一名术者操作完成。记录两组患者术前、末次随访Harris评分、术后目测类比疼痛评分、股骨头塌陷情况、术中各操作透视次数、术中出血量和手术时间。结果与结论:①所有患者获得随访,随访时间为20-38(28.53±0.50)个月;②机器人导航组患者术中X射线透视总次数、导针置入透视次数、植骨操作透视次数、植骨通道确定时间、手术时间分别为(13.84±1.52)次、(5.64±1.14)次、(8.20±1.70)次、(20.39±1.46)min和(39.37±1.96)min,均少于常规手术组上述各项指标的相应值[(18.94±1.32)次、(8.64±1.27)次、(10.30±1.79)次、(41.57±1.63)min和(62.53±3.44)min,均P<0.05];③两组在末次Harris评分、术后目测类比疼痛评分、股骨头塌陷情况和术中出血量之间比较差异无显著性意义(P>0.05);④结果说明,骨科机器人导航辅助下进行髓芯减压植骨治疗ARCOⅡ期股骨头坏死可明显提高髓芯减压植骨操作的精准度,减少术中透视次数,缩短手术时间,降低术后并发症出现的概率。BACKGROUND:Core decompression and bone grafting is one of the main hip preservation methods for ARCO II osteonecrosis of the femoral head,but the traditional surgical methods have disadvantages such as long fluoroscopy time and large amount of blood loss.OBJECTIVE:To analyze the clinical characteristics of robot-assisted core decompression and bone grafting for the treatment of ARCO II osteonecrosis of the femoral head,and to provide new ideas for hip preservation treatment of osteonecrosis of the femoral head.METHODS:A retrospective analysis was performed in 100 patients who underwent core decompression and bone grafting for osteonecrosis of the femoral head in the Department of Osteonecrosis and Joint Reconstruction,Honghui Hospital,Xi’an Jiaotong University from June 2017 to December 2019.Among them,50 patients(36 males and 14 females)underwent core decompression and bone grafting assisted by orthopaedic robot navigation.The age ranged from 30 to 74(47.52±12.50)years old and they were set as the robot navigation group.A total of 50 patients,including 37 males and 13 females,aged from 28 to 77(50.68±13.60)years,who underwent core decompression and bone grafting,were enrolled as the conventional operation group.All operations were performed by the same surgeon.The preoperative,last follow-up Harris score,postoperative visual analog scale score,femoral head collapse,intraoperative fluoroscopy times,intraoperative blood loss and operation time were recorded in the two groups.RESULTS AND CONCLUSION:(1)All patients were followed up for 20-38(28.53±0.50)months.(2)The total number of intraoperative X-ray fluoroscopy,the number of guide wire placement fluoroscopy,the number of bone graft fluoroscopy,the determination time of bone graft channel,and the operation time were(13.84±1.52)times,(5.64±1.14)times,(8.20±1.70)times,(20.39±1.46)minutes,and(39.37±1.96)minutes,respectively in the robot navigation group,and(18.94±1.32)times,(8.64±1.27)times,(10.30±1.79)times,(41.57±1.63)minutes,and(62.53±3.44)minutes,r

关 键 词：股骨头坏死 机器人辅助导航 髓芯减压植骨术 透视次数 股骨头塌陷 

分 类 号：R459.9[医药卫生—治疗学] R496[医药卫生—临床医学] R318