机器人辅助与常规全膝关节置换比较△

Comparison of robot-assisted total knee arthroplasty versus conventional counterpart /

摘要:

[目的] 评价机器人辅助全膝关节置换术 （total knee arthroplasty, TKA） 的早期临床结果。[方法] 2023 年 6 月—11 月本院收治的 130 例膝关节骨关节炎患者，使用随机数表法按 1∶1 的比例分为两组，65 例采用机器人辅助 TKA，另外 65 例采用常规 TKA。比较两组围手术期、随访及影像学资料。[结果] 机器人组患者手术时间 [(95.1±9.1) min vs (81.8±8.1) min, P＜ 0.001]、切口长度 [(14.9±0.5) cm vs (14.1±0.8) cm, P＜0.001] 均显著长于常规组。与术前相比，末次随访两组患者 VAS、KSS、 WOMAC 评分及膝 ROM 均显著改善 （P＜0.05），相应时间点，两组间上述指标的差异均无统计学意义 （P＞0.05）。辅助检查方面，两组患者术后 3 d 的 Hb、HCT、WBC、NLR、ESR 及 CRP 比较的差异均无统计学意义 （P＞0.05）。但是，术后 3 d 机器人组冠状面股骨组件角 [(89.1±1.0)° vs (87.6±1.9)°, P＜0.001]、矢状面胫骨组件角 [(86.8±0.9)° vs (85.9±2.3)°, P=0.006]、髋-膝-踝角 [(179.1±1.0)° vs (176.7±1.7)°, P＜0.001] 均显著优于常规组，两组冠状面胫骨组件角、矢状面股骨组件角比较的差异无统计学意义 （P＞0.05）。[结论]机器人辅助全膝关节置换术可以获得良好下肢力线重建及假体精准置入，是一种安全、有效的手术方式。

Abstract:

[Objective] To evaluate the early clinical consequences of robot-assisted total knee arthroplasty (TKA). [Methods] From June to November 2023, 130 patients who admitted to our hospital for knee osteoarthritis were divided into two groups according to the ratio of 1:1 using random number table method. Of them, 65 patients received robot-assisted TKA, while other 65 patients received conventional TKA. The documents regarding to perioperative period, follow-up and images of the two groups were compared. [Results] The robot group consumed significantly longer operative time [(95.1±9.1) min vs (81.8±8.1) min, P＜0.001], associated with significantly longer incision length [(14.9 ± 0.5) cm vs (14.1 ± 0.8) cm, P＜0.001] than the conventional group. Compared with those preoperatively, the VAS, KSS, WOMAC scores and knee range of motion (ROM) were significantly improved in both groups at the last follow-up (P＜0.05), which proved not statistically significant between the two groups at any corresponding time points (P＞0.05). As for auxiliary examinations, there were no statistically significant differences in Hb, HCT, WBC, NLR, ESR and CRP between the two groups 3 days after surgery (P＞0.05). However, the robot group was significantly superior to the conventional group in terms of postoperative frontal femoral component (FFC) angle [(89.1± 1.0)° vs (87.6±1.9)°, P＜0.001], lateral tibia component (LTC) angle [(86.8±0.9)° vs (85.9±2.3)°, P=0.006], hip-knee-ankle (HKA) angle [(179.1±1.0)° vs (176.7±1.7)°, P＜0.001], despite of the fact that there was no significant difference in frontal tibial component (FTC) angle and lateral femoral component (LFC) angle between the two groups (P＞0.05). [Conclusion] Robot-assisted total knee arthroplasty is a safe and effective surgical method, which can achieve good reconstruction of lower limb alignment and precise placement of prosthetic components.