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Mako机器人辅助全膝关节置换术在膝骨性关节炎的早期应用
Hits: 2041   Download times: 725   Received:October 26, 2022    
作者Author单位UnitE-Mail
汝跃方 RU Yue-fang 浙江大学医学院附属第二医院骨科, 浙江 杭州 310009
浙江大学医学院附属第二医院嘉善分院骨科, 浙江 嘉善 314100
Department of Orthopaedics, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang, China
Department of Orthopaedics, Jiashan Branch, the Second Affiliated Hospital of Zhejiang University School of Medicine, Jiashan 314100, Zhejiang, China
 
何荣新 HE Rong-xin 浙江大学医学院附属第二医院骨科, 浙江 杭州 310009 Department of Orthopaedics, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang, China herongxin@zju.edu.Cn 
期刊信息:《中国骨伤》2023年36卷,第2期,第133-139页
DOI:10.12200/j.issn.1003-0034.2023.02.008


目的:探讨Mako机器人辅助人工全膝关节置换术(total knee arthroplasty,TKA)治疗膝骨性关节炎(knee osteoarthritis,KOA)早期疗效,总结初步应用经验。

方法:回顾分析2021年6月至2021年12月,采用Mako机器人辅助TKA治疗73例KOA患者。男16例,女57例,年龄54~81(67.8±6.6)岁。记录分析患者术前术后髋膝踝角(hip-knee-ankle,HKA)、股骨远端外侧角(lateral distal femoral angle,LDFA)、胫骨近端内侧角(medial proximal tibial angle,MPTA),矢状位股骨角(lateral femoral component angle,LFCA)、矢状位胫骨角(lateral tibial component angle,LTCA)。采用Western Ontario McMater大学骨性关节炎指数(Western Ontario McMaster Universities osteoarthritis index,WOMAC)评分和美国膝关节协会评分(Knee Society scores,KSS),比较术前与术后3、6个月患者功能恢复情况。

结果:73例患者均顺利完成手术,术中无血管、神经损伤等严重并发症,术后切口均Ⅰ期甲级愈合,无感染。随访时间4~11(7.0±2.7)个月,末次随访患者满意度为90.41%(66/73)。WOMAC评分术后3个月(23.1±5.4)分,6个月(14.8±4.1)分;KSS临床评分术后3个月(76.1±4.0)分,6个月(82.1±3.7)分;KSS功能评分术后3个月(74.3±3.1)分,6个月(78.6±2.1)分。术后影像检查显示假体位置良好,HKA为(178.5±2.1)°,LDFA为(91.2±1.8)°,MPTA为(89.9±1.5)°,LFCA为(7.6±3.1)°,LTCA为(88.2±1.1)°,术后机械轴在±3°范围内病例为60例(82.2%),所有病例机械轴在±6°范围内。

结论:Mako机器人辅助TKA治疗膝骨性关节炎是一种安全有效的手术方法,在恢复下肢力线、平衡软组织、改善膝关节功能方面效果明显,远期疗效有待进一步随访观察。
[关键词]:全膝关节置换术  Mako机器人辅助  治疗结果  回顾性分析
 
Early clinical application of Mako robot-assisted total knee arthroplasty in knee osteoarthritis
Abstract:

Objective To investigate the early efficacy of Mako robot-assisted total knee arthroplasty (TKA) in the treatment of knee osteoarthritis (KOA) and summarize the initial application experience.

Methods Retrospective analysis of 73 patients with KOA treated with Mako robot-assisted TKA from June 2021 to December 2021.There were 16 males and 57 females,aged from 54 to 81 years old with an average of (67.8±6.6) years old.The hip knee and ankle angle (HKA),lateral distal femoral angle (LDFA),medial proximal tibial angle (MPTA),lateral femoral component angle (LFCA) and lateral tibial component angle (LTCA) were recorded and analyzed.WOMAC score and KSS were used to compare the functional recovery of patients preoperatively,3 and 6 months postoperatively.

Results All the 73 patients were successfully treated without serious complications such as vascular and nerve injury,and all the incisions healed well at stageⅠwithout infection.The patients were followed up from 4 to 11 months with an average of (7.0±2.7) months,and the satisfaction rate of the last follow-up was 90.41%(66/73).WOMAC scores were (23.1±5.4) at 3 months and (14.8±4.1) at 6 months postoperatively.KSS clinical scores were (76.1±4.0) at 3 months and (82.1±3.7) at 6 months postoperatively;KSS functional scores were (74.3±3.1) at 3 months and (78.6±2.1) at 6 months after operation.Postoperative imaging showed good position of the prosthesis,HKA angle was (178.5±2.1)°,LDFA was (91.2±1.8)°,MPTA was (89.9±1.5)°,LFCA was (7.6±3.1)°,LTCA was (88.2±1.1)°.The mechanical axis within ±3° in sixty cases (82.2%),and the mechanical axis within ±6° in all the patients.

Conclusion Mako robot-assisted TKA is a safe and effective surgery in the treatment of knee osteoarthritis,which exhibited good efficacy in the correction of lower limb alignment,soft tissue balance and improvement of knee function.The long-term efficacy needs further follow-up observation.
KEYWORDS:Total knee arthroplasty  Mako robot-assisted surgery  Treatment outcome  Retrospective analysis
 
引用本文,请按以下格式著录参考文献:
中文格式:汝跃方,何荣新.Mako机器人辅助全膝关节置换术在膝骨性关节炎的早期应用[J].中国骨伤,2023,36(2):133~139
英文格式:RU Yue-fang,HE Rong-xin.Early clinical application of Mako robot-assisted total knee arthroplasty in knee osteoarthritis[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(2):133~139
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