文章摘要
张鹏远,马明阳,孔祥朋,等.MAKO机器人辅助与传统手工全膝关节置换术后下肢力线的对比研究.骨科,2023,14(2): 155-160.
MAKO机器人辅助与传统手工全膝关节置换术后下肢力线的对比研究
Accuracy of Limb Alignment after MAKO Robot-assisted Total Knee Arthroplasty
投稿时间:2022-08-30  
DOI:DOI:10.3969/j.issn.1674-8573.2023.02.012
中文关键词: 骨关节炎  类风湿性关节炎  机器人辅助手术  关节成形术,置换,膝  精准性
英文关键词: Osteoarthritis  Rheumatoid arthritis  Robot-assisted surgery  Arthroplasty, replacement, knee  Accuracy
基金项目:
作者单位E-mail
张鹏远 新乡医学院第三附属医院创伤医学科河南新乡 453000中国人民解放军总医院第四医学中心骨科医学部北京 100853国家骨科与运动康复临床研究中心北京 100853  
马明阳 中国人民解放军总医院第四医学中心骨科医学部北京 100853国家骨科与运动康复临床研究中心北京 100853解放军医学院北京 100853  
孔祥朋 中国人民解放军总医院第四医学中心骨科医学部北京 100853国家骨科与运动康复临床研究中心北京 100853  
李小娅 中国人民解放军总医院第四医学中心骨科医学部北京 100853国家骨科与运动康复临床研究中心北京 100853  
柴伟 中国人民解放军总医院第四医学中心骨科医学部北京 100853国家骨科与运动康复临床研究中心北京 100853  
谷旺 中国人民解放军总医院第四医学中心骨科医学部北京 100853国家骨科与运动康复临床研究中心北京 100853 116228588@163.com 
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中文摘要:
      目的 比较MAKO机器人辅助与传统手工全膝关节置换术(TKA)术后下肢力线的准确性。方法 对2021年5月至2021年12月在解放军总医院第四医学中心骨科医学部关节外科行TKA治疗的74例(78膝)病人的临床资料进行回顾性分析,其中采用MAKO机器人辅助下TKA的37例(41膝)纳入机器人组,同期使用相同膝关节假体行传统手工手术的37例(37膝)纳入传统手工组。分别记录两组病人术中计划与术后实际测量的胫骨近端内侧角(MPTA)、股骨远端外侧角(LDFA)和下肢力线髋-膝-踝(hip-knee-ankle,HKA)角,并进行组内及组间分析比较。结果 两组病人均顺利完成手术,术后无手术相关并发症。机器人组的手术时间长于传统手工组[(110.67±80.56) min vs. (80.56±4.64) min],差异有统计学意义(t=12.726,P<0.001)。机器人组术后测量的MPTA、LDFA与术中末次计划的比较,差异均有统计学意义(P<0.05);但其计划和实际的HKA比较,差异无统计学意义(P>0.05)。传统手工组术后测量的MPTA、HKA与术中末次计划的比较,差异均有统计学意义(P<0.05);但其计划和实际的LDFA比较,差异无统计学意义(P>0.05)。通过计算两组病人计划与实际测量的差值,并进行比较,组间差异均有统计学意义(P<0.05)。结论 MAKO机器人辅助下行TKA术后下肢力线及假体位置平均误差在1°以内,机器人辅助技术有助于精准安放假体,并实现计划力线。
英文摘要:
      Objective To compare the accuracy of lower limb alignment after MAKO robot-assisted and conventional manual total knee replacement (TKA). Methods A total of 74 patients (78 knees) who underwent TKA in Fourth Medical Center of General Hospital of PLA from May 2021 to December 2021 were selected and their clinical data were analyzed retrospectively. In these 74 patients (78 knees), 37 patients (41 knees) who underwent TKA assisted by MAKO robot served as the robot group, and 37 patients (37 knees) who underwent manual TKA as the traditional manual group. Medial proximal tibia angle (MPTA), lateral distal femoral angle (LDFA) and hip-knee-ankle (HKA) were recorded before and after surgery. The above data were used for intra-group and inter-group comparisons. Results All patients in the two groups were successfully given the TKA without surgery-related complications. The operative time in the robot group was (110.67±80.56) min, which was significantly longer than that in the traditional TKA group [(80.56±4.64) min] (t=12.726, P<0.001). The postoperative MPTA and LDFA in the robot group showed statistically significant difference from those in the final intraoperative plan (P<0.05). However, there was no significant difference between planned HKA and actual HKA (P>0.05). The postoperative MPTA and HKA in the traditional manual group showed statistically significant difference from the final intraoperative plan (P<0.05). However, there was no significant difference between planned LDFA and actual LDFA (P>0.05). There was significant difference in the actual and planned values between two groups (P<0.05). Conclusion The average error of lower limb alignment and prosthesis position after TKA assisted by MAKO robots is less than 1°. Robot-assisted technology is helpful for accurate placement of prosthesis and the realization of planned lower limb alignment.
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