国产机器人辅助全膝关节置换术的精准度和短期临床疗效  

Early Clinical and Radiographic Outcomes of Domestic Robot-assisted Total Knee Arthroplasty

作　　者：杜敏聪 李征[1] 江云飞 谢天朗 孙文轩 李千里 杨士慷 吴江鹏 曹光磊[1] Du Mincong;Li Zheng;Jiang Yunfei;Xie Tianlang;Sun Wenxuan;li Qianli;Yang Shikang;Wu Jiangpeng;Cao Guanglei(Department of Orthopaedics,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院骨科,北京100053

出　　处：《实用骨科杂志》2023年第6期502-508,共7页Journal of Practical Orthopaedics

基　　金：北京市医院管理中心临床医学发展专项经费资助(XMLX202139)。

摘　　要：目的探究国产机器人辅助全膝关节置换术(robot-assisted total knee arthroplasty,RATKA)的影像学精准度和临床疗效。方法采用前瞻随机对照研究,以2021年10月至2022年3月期间符合纳入排除标准的拟行TKA手术的患者为研究对象,最终共纳入23例患者。通过随机信封法分为RATKA组和传统TKA组。RATKA组患者11例,男3例,女8例;平均年龄(68.7±7.8)岁。传统TKA组患者12例,男1例,女11例;平均年龄(70.8±5.0)岁。测算两组患者下肢力线和假体位置角度以评估影像学精准度,记录两组手术时间、失血量、功能评分、围术期并发症等以评估临床疗效结果。结果影像学精准度指标上,RATKA组的髋-膝-踝角(hip-knee-ankle angle,HKA)偏离值小于传统TKA组,分别为(1.16±1.14)°及(2.56±1.90)°,P=0.047;矢状面胫骨角(lateral tibia component,LTC)偏离值也小于传统TKA组,分别为(0.95±0.71)°及(1.75±0.98)°,P=0.039;其余角度的偏离值比较差异无统计学意义(P>0.05)。临床疗效指标上,RATKA组总手术时间较传统TKA组延长,分别为(125.0±8.4)min及(101.0±28.5)min,P=0.027;在截骨时间、围术期失血量、膝关节活动度(range of motion,ROM)及功能评分上差异无统计学意义(P>0.05)。两组患者围术期并发症发生率差异无统计学意义(P>0.05)。结论国产机器人在辅助行初次人工全膝关节置换时可以提高下肢力线重建和矢状位胫骨假体安装的精准度,且安全可靠,值得在临床中推广应用。Objective To explore the short-term clinical and radiographic outcomes of domestic robot assisted total knee arthroplasty(RATKA).Methods A prospective randomized controlled study was conducted.The patients who met the inclusion and exclusion criteria for TKA surgery during the period from October 2021 to March 2022 were selected and divided into RATKA group and conventional group randomly.A total of 23 patients were finally included and divided into RATKA group and conventional TKA group by random envelope method.There were 11 patients in the RATKA group,among them 3 males and 8 females.Their mean age is(68.7±7.8)years old.There were 12 patients in the traditional TKA group,which had 1 male and 11 females.Their mean age was(70.8±5.0)years old.The radiographical accuracy indicators of the two groups of patients were recorded and analyzed as well as clinical efficacy indicators,including the lower limb alignment and prosthesis position,operation time,blood loss,functional score,perioperative complications,etc.Results For radiographical indicators,the deviation value of HKA in RATKA group was lower than that in conventional TKA group,which were(1.16±1.14)°and(2.56±1.90)°,P=0.047,respectively.The deviation value of LTC was also lower than that in traditional TKA group,which were(0.95±0.71)°and(1.75±0.98)°,P=0.039.The operation time in RATKA group was(125.0±8.4)min,which was significantly longer than that in traditional TKA group(101.0±28.5)min,P=0.027.As for the osteotomy time,perioperative blood loss,range of motion(ROM),clinical scores,there was no statistically significant difference(P>0.05).There was no significant difference in the incidence of perioperative complications between the two groups(P>0.05).Conclusion With the help of domestic RATKA system,the initial total knee replacement is more accurate in lower limb alignment and lateral tibial prosthesis installation.It’s safe,reliable and worth promotion in clinic.

关 键 词：机器人辅助 全膝关节置换术 膝关节骨关节炎 

分 类 号：R687.42[医药卫生—骨科学]