双侧同期Mako机器人辅助与传统全膝关节置换术治疗膝骨关节炎的疗效比较  

Clinical efficacy comparison of bilateral simultaneous Mako robot-assisted and traditional total knee arthroplasty in the treatment of bilateral knee osteoarthritis

作　　者：马桥桥 郝亮 蒋守海 郭开今 张传开 Ma Qiaoqiao;Hao Liang;Jiang Shouhai;Guo Kaijin;Zhang Chuankai(Department of Orthopedic Surgery,Xuzhou Renci Hospital,Xuzhou 221000,China;Department of Orthopedic Surgery,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China)

机构地区：[1]徐州仁慈医院关节科,徐州221000 [2]徐州医科大学附属医院关节科,徐州221000

出　　处：《中华解剖与临床杂志》2024年第6期405-411,共7页Chinese Journal of Anatomy and Clinics

基　　金：江苏省基础研究计划(BK20201154);徐州仁慈医院院级科研项目(XZRCKY-KT-202401005)。

摘　　要：目的对比双侧同期Mako机器人辅助全膝关节置换术(TKA)与传统TKA治疗膝骨关节炎的临床疗效。方法前瞻性对照研究。纳入2021年8月—2022年8月在徐州仁慈医院关节科接受双侧TKA的膝骨关节炎患者25例(50膝),其中男11例、女14例,年龄51~82(64.7±14.8)岁。采用信封法将患者的左右两侧膝关节随机分为2组:采用Mako机器人辅助TKA为MA-TKA组;采用传统人工TKA为CM-TKA组。观察指标:(1)比较2组膝关节切口长度、手术时间、术中出血量,以及术中膝关节屈曲间隙差(FGD)、膝关节伸直间隙差(EGD)的差异。(2)比较2组膝关节术前和术后第3天髋-膝-踝(HKA)角差异。(3)比较2组膝关节术前和术后不同时间点的疼痛视觉模拟评分法(VAS)评分、膝关节协会临床评分系统(KSS)功能评分、膝关节主动活动度(ROM)差异。(4)术后12个月比较2组膝关节的患者满意度。结果25例患者均成功完成同期双侧TKA手术。术后患者均获随访12个月。(1)MA-TKA组手术时间(105.8±16.7)min较CM-TKA组(86.3±14.5)min长,术中FGD和EGD在MA-TKA组均小于CM-TKA组,差异均有统计学意义(P值均<0.05);切口长度、术中出血量、并发症比较,差异均无统计学意义(P值均>0.05)。(2)术前2组间HKA角差异无统计学意义(P>0.05);术后第3天均较术前减小,差异均有统计学差异(P值均<0.05);MA-TKA组术后第3天的HKA角(2.3°±1.3°)较CM-TKA组(3.5°±2.2°)更小,差异有统计学意义(t=2.93,P=0.007)。(3)2组患者术前膝关节疼痛VAS评分、KSS功能评分、ROM差异均无统计学意义(P值均>0.05)。组内比较:术后不同时间点膝关节疼痛VAS评分、KSS功能评分、ROM均较术前明显改善,组内两两比较除术后6个月与12个月的VAS评分差异无统计学意义(P>0.05)外,其余指标差异均有统计学意义(P值均<0.05)。组间比较:MA-TKA组术后不同时间点VAS评分、KSS功能评分、ROM均优于CM-TKA组,其中术后第1、7天VAS评分和术后1个月时Objective This study aimed to compare the clinical outcomes between simultaneous bilateral Mako robot-assisted and conventional total knee arthroplasty(TKA).Methods This was a prospective controlled study.A total of 25 patients(50 knees)with knee osteoarthritis,including 11 males and 14 females,aged 51-82(64.7±14.8)years,received bilateral TKA in the arthrosis Department of Xuzhou Renci Hospital from August 2021 to August 2022.The left and right knee joints of the patients were randomly divided into two groups by using the envelope method.Mako robot-assisted TKA(MA-TKA group)and conventional manual total knee arthroplasty(CM-TKA group)were respectively treated.The observation indicators were as follows.(1)Differences in cut length,knee operation time,intraoperative blood loss,knee flexion gap difference,and knee extension gap difference between the two groups were compared.(2)The difference in hip knee ankle(HKA)angle between the two groups before surgery and the third day after surgery was compared.(3)Visual analog scale(VAS score),Knee Association Clinical Scoring System(KSS)function score,and active knee range of motion(ROM)were compared between the two groups at different time points before and after knee operation.(4)The satisfaction of knee-joint patients in the two groups was compared 12 months after surgery.Results All 25 patients underwent bilateral TKA surgery successfully.All patients were followed up for 12 months.(1)The operative time of MA-TKA group was(105.8±16.7)min longer than that of the CM-TKA group(86.3±14.5)min,and the difference of flexion/extension gap in the MA-TKA group was smaller than that in the CM-TKA group,with statistical significance(all P values<0.05).No significant differences in incision length,intraoperative blood loss,and complications were found(all P values>0.05).(2)No significant difference in HKA Angle existed between the two groups before surgery(P>0.05).On the 3rd day after operation,the value decreased compared with that before operation,with statistical difference(a

关 键 词：骨关节 膝 关节成形术 置换 膝 Mako机器人辅助手术 传统术式 疗效比较 

分 类 号：R687.4[医药卫生—骨科学]