ARTHROBOT机器人辅助全髋置换术的早期结果  

Early results of ARTHROBOT robot-assisted total hip arthroplasty

作　　者：贾若真 韩衍龙 王利[1] JIA Ruo-zhen;HAN Yan-long;WANG Li(Geriatric Ward,Orthopedics and Joint Surgery Center,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830000,China;Postgradu-ate School,Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆维吾尔自治区人民医院骨科中心关节老年病区,新疆乌鲁木齐830000 [2]新疆医科大学研究生学院,新疆乌鲁木齐830054

出　　处：《中国矫形外科杂志》2024年第9期787-793,共7页Orthopedic Journal of China

基　　金：新疆维吾尔自治区自然科学基金资助项目(编号:2022D01C146)。

摘　　要：[目的]比较机器人ARTHROBOT辅助全髋置换术(robot-assisted total hip arthroplasty,r THA)与传统手工全髋置换术(manual total hip arthroplasty,mTHA)的早期效果。[方法]回顾性分析2022年4月—2022年11月本院行THA的58例患者的临床资料。根据术前医患沟通结果,28例采用rTHA,另外30例采用mTHA,对比两组围手术期、随访及影像学资料。[结果]两组患者均手术顺利,未见术中并发症。rTHA组手术时间、切口总长度、治疗费用均显著大于mTHA组(P<0.05)。rTHA组术后无脱位者,而mTHA组1例因假体位置不良,脱位,行翻修术。随时间推移,两组患者VAS评分、Harris评分、髋伸-屈及内-外旋ROM均显著改善(P<0.05)。rTHA组Harris评分术后1个月[(70.8±3.3)vs(68.2±5.1),P=0.043]、末次随访时[(92.0±3.6)vs(89.7±4.2),P=0.025]及术后6个月髋内-外旋ROM[(48.5±5.9)°vs(44.1±6.6)°,P=0.009]均显著优于mTHA组。影像方面,rTHA组术后双下肢长度差(leg length discrepancy,LLD)[(0.4±0.2)mm vs(0.6±0.3)mm,P=0.003]、双侧股骨偏心距(femoral offset deviation,FOD)差值[(0.3±0.2)mm vs(0.7±0.5)mm,P<0.001]、双侧髋臼偏心距(acetabular offset deviation,AOD)差值[(0.3±0.2)mm vs(0.5±0.3)mm,P=0.004]和联合偏心距(combined offset deviation,COD)差值[(0.4±0.4)mm vs(0.8±0.6)mm,P<0.001]均显著小于mTHA组,而两组髋臼外展角(acetabular abduction angle,AAA)和髋臼前倾角(acetabular anteversion,AA)差异无统计学意义(P>0.05)。以Lewinnek安全区为标准,rTHA组安全区内病例数占比[例(%),26(92.9)vs 21(70.0),P=0.026]显著高于mTHA组(P<0.05)。[结论]机器人ARTHROBOT辅助THA使假体置入更精准,髋臼杯置入安全区的比例更高,能更好恢复患髋偏心距,有利于减少LLD,疗效更佳。[Objective]To compare the early clinical outcomes of robot-assisted total hip arthroplasty(rTHA)with manual total hip arthroplasty(mTHA).[Methods]A retrospective research was performed on 58 patients who underwent THA in our hospital from April 2022 to November 2022.According to preoperative doctor-patient communication,28 patients underwent the rTHA,while other 30 patients had the conventional mTHA performed.The perioperative period,follow-up and imaging data of the two groups were compared.[Results]All patients in both groups had corresponding THA conducted successfully,with no intraoperative complications.The rTHA consumed significantly longer operation time,with significantly greater total incision length and treatment cost than those of the mTHA group(P<0.05).However,no postoperative dislocation happened in the rTHA group,while 1 case in the mTHA group underwent revision for dislocation due to poor placement of the prosthesis.The VAS score,Harris score,hip extension-flexion and internal-external rotation(ROM)were significantly improved in both groups over time(P<0.05).The rTHA group proved significantly superior to the mTHA group in terms of Harris score 1 month after operation[(70.8±3.3)vs(68.2±5.1),P=0.043]and at the last follow-up[(92.0±3.6)vs(89.7±4.2),P=0.025],as well as internalexternal rotation ROM 6 months postoperatively[(48.5±5.9)°vs(44.1±6.6)°,P=0.009].With respect of imaging,the rTHA group was significantly better than the mTHA in terms of leg length discrepancy(LLD)[(0.4±0.2)mm vs(0.6±0.3)mm,P=0.003],bilateral difference of femoral offset deviation(FOD)[(0.3±0.2)mm vs(0.7±0.5)mm,P<0.001],bilateral difference of acetabular offset deviation(AOD)[(0.3±0.2)mm vs(0.5±0.3)mm,P=0.004],and bilateral difference of combined offset deviation(COD)[(0.4±0.4)mm vs(0.8±0.6)mm,P<0.001],despite of that there was no significant difference in acetabular abduction angle(AAA)and acetabular anteversion(AA)between the two groups(P>0.05).Taking Lewinnek safe zone as the standard,the rTHA group was also

关 键 词：机器人辅助手术 髋关节置换 假体位置 偏心距 下肢长度差 

分 类 号：R687.4[医药卫生—骨科学]