MAKO机器人与导航辅助膝关节置换:下肢力线及假体位置准确性比较  

MAKO robot-and navigation-assisted knee replacement:comparison of lower limb force alignment and prosthesis position accuracy

作　　者：蒋涛 张传开 郝亮 刘勇 Jiang Tao;Zhang Chuankai;Hao Liang;Liu Yong(Xuzhou Renci Hospital,Xuzhou 221001,Jiangsu Province,China)

机构地区：[1]徐州仁慈医院,江苏省徐州市221001

出　　处：《中国组织工程研究》2025年第33期7150-7157,共8页Chinese Journal of Tissue Engineering Research

摘　　要：背景:膝关节置换是治疗严重膝关节疾病的成功技术,但仍然存在如手术精度不高、手术时间长、术后恢复周期长等问题,智能骨科机器人的临床应用能解决这些问题,使膝关节置换技术更加优化。目的:比较MAKO机器人与计算机导航辅助膝关节置换的疗效。方法:选择2022年1-12月徐州仁慈医院收治的MAKO机器人辅助膝关节置换的25例患者作为观察组,并选取同期采用计算机导航辅助膝关节置换的患者100例作为对照组。比较两组患者围术期相关指标,计划与实际胫骨近端内侧角、股骨远端外侧角、髋-膝-踝角,术前、术后3个月目测类比评分、关节活动度、美国膝关节协会临床评分及功能评分、西安大略和麦克马斯特大学骨关节炎指数各维度评分。结果与结论:①与对照组相比,观察组手术时间延长(P<0.05),术中出血量减少(P<0.05);②观察组胫骨近端内侧角、股骨远端外侧角、髋-膝-踝角术中计划与术后测量差值与对照组相比,均显著减小(P<0.05);③术后3个月,两组目测类比评分均较术前降低(P<0.05),关节活动度均较术前升高(P<0.05);观察组目测类比评分显著低于对照组,关节活动度显著大于对照组(P<0.05);④术后3个月,两组患者美国膝关节协会临床、功能评分均较术前升高(P<0.05),且观察组高于对照组(P<0.05);⑤术后3个月,两组患者西安大略和麦克马斯特大学骨关节炎指数功能、僵硬、疼痛评分均较术前降低(P<0.05),且观察组低于对照组(P<0.05);⑥提示与计算机导航膝关节置换相比,MAKO机器人辅助膝关节置换可减少术中出血量,降低下肢力线及假体位置误差,有助于精准安放假体,并实现计划力线,减轻术后疼痛,改善膝关节活动度,促进膝关节功能的恢复。BACKGROUND:Knee replacement is a successful technology for treating severe knee diseases,but there are still problems such as low surgical precision,long operation time,and long postoperative recovery period.The clinical application of intelligent orthopedic robots can solve these problems and make knee replacement technology more optimized.OBJECTIVE:To compare the efficacy of MAKO robot-assisted knee replacement with navigation knee replacement.METHODS:Twenty-five patients treated with MAKO robot-assisted knee replacement in Xuzhou Renci Hospital from January to December 2022 were selected as observation group.100 patients treated with navigation knee replacement during the same period were selected as the control group.Perioperative related indexes of the two groups were compared,including planned and actual medial proximal tibial angle,distal lateral femoral angle,hip-knee-ankle angle,visual analog scale score,joint range of motion,American Knee Society functional score,and Western Ontario and McMaster University Osteoarthritis Index score before and 3 months after surgery.RESULTS AND CONCLUSION:(1)The operation time of observation group was significantly longer than that of the control group(P<0.05),and the intraoperative blood loss was significantly less(P<0.05).(2)The difference of medial proximal tibial angle,distal lateral femoral angle,and hip-knee-ankle angle in observation group was significantly lower than that in the control group(P<0.05).(3)Three months after surgery,visual analog scale score in both groups was lower than that before surgery(P<0.05);range of motion in both groups was higher than that before surgery(P<0.05).Visual analog scale score in observation group was significantly lower than that in the control group,and range of motion in observation group was significantly higher than that in the control group(P<0.05).(4)Three months after surgery,the clinical and functional scores of American Knee Society in both groups were higher than those before surgery(P<0.05),and those in observation

关 键 词：膝关节置换 MAKO机器人 计算机导航 膝关节功能 下肢力线 膝关节活动度 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R682