机器人辅助人工全髋关节置换术对下肢长度和偏心距恢复的影响  

Impact of robot assistance on restoration of limb length and offset distance in total hip arthroplasty

作　　者：袁子祁 李杨[1] 田华[1] YUAN Ziqi;LI Yang;TIAN Hua(Department of Orthopedics,Peking University Third Hospital,Engineering Research Center of Bone and Joint Precision Medicine,Ministry of Education,Beijing,100191,P.R.China)

机构地区：[1]北京大学第三医院骨科,骨与关节精准医学教育部工程研究中心,北京100191

出　　处：《中国修复重建外科杂志》2024年第11期1307-1311,共5页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：北京大学第三医院人才孵育基金(BYSYFY2021043)。

摘　　要：目的探讨机器人辅助人工全髋关节置换术(total hip arthroplasty,THA)中对下肢长度和偏心距恢复的影响。方法回顾性分析2019年9月—2023年8月316例符合选择标准的单侧初次THA患者临床资料。采用机器人辅助THA 117例(A组)、传统THA 199例(B组)。两组患者性别、年龄、置换侧别比较,差异均无统计学意义(P>0.05);术前诊断组间比较差异有统计学意义(P<0.05)。基于术后骨盆正位X线片测量双下肢不等长(limb length discrepancy,LLD)及联合偏心距(global offset,GO)差值,取绝对值进行组间比较。结果两组手术均顺利完成。术后影像学测量示A组LLD、GO差值均低于B组,差异有统计学意义(P<0.05)。其中,A组LLD>3 mm、>5 mm、>10 mm患者分别为32例(27.4%)、5例(4.3%)、0例(0),B组为115例(57.8%)、75例(37.7%)、22例(11.1%);上述组间差异均有统计学意义(P<0.05)。A组GO差值>5 mm、>10 mm、>20 mm患者分别为40例(34.2%)、3例(2.6%)、0例(0),B组分别为103例(51.8%)、54例(27.1%)、7例(3.5%);除>20 mm组间差异无统计学意义(P>0.05)外,其余组间差异有统计学意义(P<0.05)。结论与传统THA相比,机器人辅助THA在下肢长度和偏心距恢复方面更具优势。Objective To analyze the impact of robot assistance on the restoration of limb length and offset distance in total hip arthroplasty(THA).Methods A retrospective analysis was conducted on the clinical data of 316 patients who underwent unilateral primary THA between September 2019 and August 2023.Among them,117 patients underwent robot-assisted THA(group A),and 199 patients underwent conventional THA(group B).There was no significant difference between the two groups in the gender,age,or side of the hip replacement(P>0.05);but there was a significant difference in the preoperative diagnosis(P<0.05).The leg length discrepancy(LLD)and global offset(GO)dfference were measured on preoperative anteroposterior pelvic X-ray films,and absolute values were used for comparison between groups.Results The operations in both groups were successfully completed.Postoperative imaging measurements showed that the LLD and GO dfference in group A were significantly lower than those in group B(P<0.05).Among them,group A had 32 cases(27.4%),5 cases(4.3%),and 0 case(0)of LLD>3 mm,>5 mm,and>10 mm,respectively,while group B had 115 cases(57.8%),75 cases(37.7%),and 22 cases(11.1%),respectively;and the differences in above indicators between groups were significant(P<0.05).Group A had 40 cases(34.2%),3 cases(2.6%),and 0 case(0)of GO dfference>5 mm,>10 mm,and>20 mm,respectively;group B had 103 cases(51.8%),54 cases(27.1%),and 7 cases(3.5%),respectively.There was no significant difference in the proportion of patients with GO>20 mm between groups(P>0.05),while there were significant differences in other indicators between groups(P<0.05).Conclusion Compared with traditional THA,robot assisted THA has more advantages in restoration of limb length and offset distance.

关 键 词：机器人辅助手术 人工全髋关节置换术 双下肢不等长 联合偏心距 

分 类 号：R687.4[医药卫生—骨科学]