国产“鸿鹄”骨科手术机器人辅助与传统人工全膝关节置换术近期疗效比较研究  

A comparative study of short-term effectiveness of "SkyWalker"robot-assisted versus traditional total knee arthroplasty

作　　者：安浩铭 平航宇 李海峰[1,2] 柴伟 AN Haoming;PING Hangyu;LI Haifeng;CHAI Wei(Department of Orthopedics,the Fourth Medical Center of Chinese PLA General Hospital,Beijing,100048,P.R.China;National Clinical Research Center for Orthopedics,Sports Medicine&Rehabilitation,Beijing,100853,P.R.China;School of Medicine,Nankai University,Tianjin,300071,P.R.China)

机构地区：[1]解放军总医院第四医学中心骨科医学部,北京100048 [2]国家骨科与运动康复临床医学研究中心,北京100853 [3]南开大学医学院,天津300071

出　　处：《中国修复重建外科杂志》2023年第4期404-409,共6页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家重点研发计划资助项目(2021YFC2401304);北京市科技计划课题(Z221100003522014)。

摘　　要：目的探讨国产“鸿鹄”骨科手术机器人(以下简称“鸿鹄”机器人)辅助人工全膝关节置换术(total knee arthroplasty,TKA)与传统TKA的近期疗效差异。方法回顾分析2022年1月—3月符合选择标准的54例(54膝)TKA患者临床资料。其中,27例行传统TKA(传统手术组),27例行“鸿鹄”机器人辅助下TKA(机器人辅助手术组)。两组患者性别、年龄、身体质量指数、骨关节炎侧别、病程以及术前美国膝关节协会评分(KSS)、西安大略和麦克马斯特大学骨关节炎评分(WOMAC)、疼痛视觉模拟评分(VAS)、膝关节活动度(range of motion,ROM)、髋-膝-踝角(hip-knee-ankle angle,HKA)、股骨远端外侧角(lateral distal femoral angle,LDFA)、胫骨近端内侧角(medial proximal tibial angle,MPTA)、胫骨近端后倾角(posterior proximal tibial angle,PPTA)等基线资料比较,差异均无统计学意义(P>0.05)。记录手术时间、术中出血量及手术相关并发症;术前及术后6个月KSS、WOMAC、VAS评分及ROM,术后6个月关节置换术后忘记关节评分(FJS)。X线片复查假体情况并测量HKA、LDFA、MPTA、PPTA。计算手术前后上述临床及影像学指标差值,并进行统计分析。结果两组手术均顺利完成。两组手术时间及术中出血量比较,差异无统计学意义(P>0.05)。术后传统手术组出现切口不愈合1例、心力衰竭1例,机器人辅助手术组无手术相关并发症发生;并发症发生率分别为7.4%(2/27)及0(0/27),差异无统计学意义(P=0.491)。两组患者均获随访6个月。两组术后6个月KSS、WOMAC、VAS评分及ROM均较术前改善(P<0.05)。两组上述指标手术前后差值以及术后6个月FJS评分比较,差异均无统计学意义(P>0.05)。X线片复查示患者下肢力线均改善,膝关节假体位置良好,随访期间未出现假体松动、感染等严重不良事件。除机器人辅助组LDFA(P>0.05)外,两组术后6个月HKA、LDFA、MPTA和PPTA均较术前改善,差异有统计学意义(P<0.0Objective To compare the short-term effectiveness of"SkyWalker"robot-assisted total knee arthroplasty(TKA)and traditional TKA.MethodlssA clinical data of 54 patients(54 knees)with TKA who met the selection criteria between January 2022 and March 2022 was retrospectively analyzed.Among them,27 cases underwent traditional TKA(traditional operation group)and 27 cases underwent"SkyWalker"robot-assisted TKA(robot-assisted operation group).There was no significant difference between the two groups(P>0.05)in terms of gender,age,body mass index,osteoarthritis side,disease duration,and preoperative Knee Society Score(KsS),Western Ontario and McMaster University Osteoarthritis Index(WOMAC),visual analogue scale(VAS)score,hip-knee-ankle angle(HKA),lateral distal femoral angle(LDFA),medial proximal tibial angle(MPTA),and posterior proximal tibial angle(PPTA).The operative time,intraoperative bleeding volume,surgery-related complications,the KSS,WOMAC,and VAS scores before operation and at 6 months after operation,and Forgotten Joint Score(FJS)at 6 months after operation were recorded.X-ray films were taken to review the prosthesis position and measure HKA,LDFA,MPTA,and PPTA.The differences of the clinical and imaging indicators between before and after operation were calculated and statistically analyzed.Results The operations were completed successfully in both groups.There was no significant difference in the operative time and intraoperative bleeding volume between the two groups(P>0.05).After operation,1 case of incision nonunion and 1 case of heart failure occurred in the traditional operation group,while no surgery-related complications occurred in the robotic-assisted operation group.The incidences of surgical complications were 7.4%(2/27)in the traditional operation group and 0(0/27)in the robotic-assisted operation group,with no significant difference(P-0.491).Patients in both groups were followed up 6 months.KSS score,WOMAC score,VAS score,and ROM significantly improved in both groups at 6 months after operation wh

关 键 词：“鸿鹄”骨科手术机器人 人工全膝关节置换术 近期疗效 

分 类 号：R687.4[医药卫生—骨科学]