国产可视化导航与MAKO手术机器人辅助全髋关节置换术治疗CroweⅣ型发育性髋关节发育不良的临床效果比较  

Comparison of the clinical outcomes of domestic visual navigation and MAKO surgical robot-assisted total hip arthroplasty in the treatment of Crowe typeⅣdevelopmental dysplasia of the hip

作　　者：张博涵 郭人文 谢鸿斌 唐云皓 孔祥朋 柴伟 ZHANG Bohan;GUO Renwen;XIE Hongbin;TANG Yunhao;KONG Xiangpeng;CHAI Wei(Senior Department of Orthopaedics,the Fourth Medical Center of Chinese PLA General Hospital,Beijing 100089,China;National Clinical Research Center for Orthopedics,Sports Medicine and Rehabilitation,Beijing 100853,China)

机构地区：[1]中国人民解放军总医院第四医学中心骨科医学部,北京100089 [2]国家骨科与运动康复临床医学研究中心,北京100853

出　　处：《中华骨与关节外科杂志》2025年第1期19-26,共8页Chinese Journal of Bone and Joint Surgery

基　　金：国家自然科学基金区域联合重点项目(U22A20355)。

摘　　要：目的:比较国产可视化导航与MAKO手术机器人辅助全髋关节置换术(THA)治疗CroweⅣ型发育性髋关节发育不良(DDH)的临床效果。方法:回顾性选取2022年1月至2023年7月中国人民解放军总医院第四医学中心接受可视化导航或MAKO手术机器人辅助THA的44例(56髋)CroweⅣ型DDH患者作为研究对象,按性别、年龄、体重指数进行倾向性评分1∶1匹配,分为使用可视化导航辅助THA的导航组(23例,28髋)和使用MAKO手术机器人辅助THA的机器人组(21例,28髋)。记录两组患者围手术期相关指标(包括手术时间、术中出血量和股骨转子下截骨的发生情况),观察并比较术后12个月两组患者的假体位置(包括髋臼假体前倾角和外展角),比较术前和术后12个月两组患者髋关节影像学指标[包括髋关节旋转中心高度(V-COR)、旋转中心水平距离(H-COR)、股骨偏心距(FO)、双下肢长度差异(LLD),以及假体在位情况、截骨愈合情况、假体周围骨溶解情况]、髋关节功能[包括Harris髋关节评分(HHS)和牛津大学髋关节评分(OHS)],记录两组患者并发症的发生情况。结果:患者随访时间为12~16个月,平均(13.36±1.20)个月。导航组患者手术时间短于机器人组,术中出血量少于机器人组,差异均有统计学意义(P均<0.05)。两组患者股骨转子下截骨的发生情况比较,差异无统计学意义(P>0.05)。术后12个月,两组患者前倾角、外展角比较,差异均无统计学意义(P均>0.05)。术后12个月,两组患者V-COR、H-COR、LLD均小于本组术前,FO均大于本组术前,差异均有统计学意义(P均<0.05)。术后12个月,所有患者假体均稳定在位,未发生假体松动、骨溶解和异位骨化。术后12个月,两组患者HHS均高于本组术前,OHS均低于本组术前,差异均有统计学意义(P均<0.05)。术后12个月,导航组患者HHS高于机器人组,差异有统计学意义(P<0.05)。术后12个月,两组患者均未发生假体周围骨折、�Objective:To compare the clinical outcomes of domestic visual navigation and MAKO surgical robot-assisted total hip arthroplasty(THA)in the treatment of Crowe typeⅣdevelopmental dysplasia of the hip(DDH).Methods:A retrospective study was conducted on 44 patients(56 hips)with Crowe typeⅣDDH who underwent visual navigation or MAKO surgical robot-assisted THA at the Fourth Medical Center of Chinese PLA General Hospital from January 2022 to July 2023.Patients were matched 1∶1 according to gender,age,and body mass index,and were divided into the navigation group(23 cases,28 hips)that underwent visual navigation-assisted THA and the robot group(21 cases,28 hips)that underwent MAKO surgical robot-assisted THA.Perioperative indicators of both groups including operation time,intraoperative blood loss,and the occurrence of subtrochanteric osteotomy were recorded.The prosthesis position of both groups including the anteversion and abduction angles of the acetabular prosthesis was observed and compared at 12 months postoperatively.Hip joint imaging indicators,including vertical center of rotation(V-COR),horizontal center of rotation(H-COR),femoral offset(FO),leg length discrepancy(LLD),prosthesis position,osteotomy healing,and periprosthetic osteolysis,as well as hip joint function,including Harris Hip Score(HHS)and Oxford Hip Score(OHS)were compared preoperatively and 12-month postoperatively.Complications in both groups were also recorded.Results:All patients were followed up for 12 to 18 months,with an average of(13.36±1.20)months.The navigation group had shorter surgical times and less intraoperative blood loss compared to the robot group,with both differences being statistically significant(both P<0.05).There was no statistically significant difference in the occurrence of subtrochanteric osteotomy between the two groups(P>0.05).At 12 months postoperatively,there were no statistically significant differences between the two groups in terms of anteversion and abduction angles(both P>0.05).At 12 months postoperativ

关 键 词：可视化导航 全髋关节置换术 CroweⅣ型 发育性髋关节发育不良 

分 类 号：R687.4[医药卫生—骨科学]