| 两款不同手术机器人辅助全膝关节置换的回顾性研究 |
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Received:July 30, 2024
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| 作者 | Author | 单位 | Unit | E-Mail |
| 王洪平 |
WANG Hong-ping |
攀枝花市中心医院骨科, 四川 攀枝花 617000 |
Department of Orthopaedics, Panzhihua Central Hospital, Panzhihua 617000, Sichuan, China |
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| 王明友 |
WANG Ming-you |
攀枝花市中心医院骨科, 四川 攀枝花 617000 |
Department of Orthopaedics, Panzhihua Central Hospital, Panzhihua 617000, Sichuan, China |
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| 唐茁栋 |
TANG Zhuo-dong |
攀枝花市中心医院骨科, 四川 攀枝花 617000 |
Department of Orthopaedics, Panzhihua Central Hospital, Panzhihua 617000, Sichuan, China |
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| 陶崎峰 |
TAO Qi-feng |
攀枝花市中心医院骨科, 四川 攀枝花 617000 |
Department of Orthopaedics, Panzhihua Central Hospital, Panzhihua 617000, Sichuan, China |
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| 兰玉平 |
LAN Yu-ping |
攀枝花市中心医院骨科, 四川 攀枝花 617000 |
Department of Orthopaedics, Panzhihua Central Hospital, Panzhihua 617000, Sichuan, China |
lanyuping@sina.com |
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| 期刊信息：《中国骨伤》2024年37卷，第9期，第870-877页 |
| DOI：10.12200/j.issn.1003-0034.20240371 |
| 基金项目:2023年四川省医学会骨科(尚安通)专项科研课题(编号:2023SAT14) |
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目的: 比较国产HURWA与进口Brainlab Knee3手术机器人辅助全膝关节置换术(total knee arthroplasty,TKA)中的早期临床及影像学结果。
方法: 回顾性分析2021年1月至2023年7月采用手术机器人辅助下行TKA的93例膝骨关节炎(knee osteoarthritis,KOA)患者,根据使用机器人系统不同分为BRATKA 组和HRATKA组。BRATKA 组40例,男16例,女24 例;年龄55~90(64.3±7.0)岁;Kellgren-Lawrence(K-L)分级Ⅲ级27例,Ⅳ级13例;右侧18例,左侧22例;病程1~30(15.3±7.6)年;采用进口 Brainlab Knee3手术机器人辅助系统。HRATKA组53例,男18例,女35 例;年龄52~81(64.4±8.5)岁;K-L 分级Ⅲ级30例,Ⅳ级23例;右侧21例,左侧32例;病程1~32(16.4±7.9)年;采用国产HURWA手术机器人辅助系统。比较两组手术时间、围手术期总失血量、手术切口大小、术后并发症发生情况;比较两组术前及术后1 d髋膝踝(hip-knee-ankle angle,HKAA)偏移度,术后1 d矢状面胫骨组件角(later tibal component,LTC)、冠状面股骨组件角(frontal femoral component,FFC)、矢状面股骨组件角(later femoral component,LFC)、冠状面胫骨组件角(frontal tibal component,FTC);比较两组术前及术后3、90 d 美国膝关节协会评分(Knee Society score,KSS)、疼痛视觉模拟评分(visual analogue scale,VAS)和膝关节活动度(range of motion,ROM)。
结果: 两组术后均获得随访,时间11~18(14.4±2.1)个月,所有患者伤口愈合良好。BRATKA 组手术时间、切口长度分别为(132.1±34.6) min、(12.9±1.9) cm,HRATKA组分别为(94.1±10.8) min、(14.8±2.1) cm,两组比较差异有统计学意义(P＜0.05)。两组围手术期总失血量、术前HKAA偏移角度比较,差异无统计学意义(P＞0.05);术后 1 d,BRATKA 组HKAA偏移角、FFC角、LFC角分别为(1.90±0.91)°、(87.90±1.51)°、(9.00±3.20)°,HRATKA组分别为(0.93±1.04)°、(89.03±0.96)°、(7.63±0.59)°,两组比较差异有统计学意义(P＜0.05);而FTC、LTC比较差异无统计学意义(P＞0.05)。两组术前及术后3、90 d膝关节静息和运动VAS、KSS及膝关节ROM比较,差异均无统计学意义(P＞0.05)。两组并发症比较,差异无统计学意义(P＞0.05)。
结论: 两款机器人系统术后影像学检查方面均显示了良好的下肢力线,国产HRATKA 组较进口BRATKA 组有更好的LFC、FFC角度及HKAA偏移角度,但在术后膝关节功能及疼痛缓解程度方面无显著差异。 |
| [关键词]:膝骨关节炎 手术机器人 全膝关节置换术 |
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| A retrospective study on two different surgical robots to assist total knee arthroplasty |
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Abstract:
Objective To compare early clinical and imaging results of domestic HURWA and imported Brainlab Knee3 surgical robot-assisted knee replacement.
Methods A retrospective analysis was performed on 93 patients with knee osteoarthritis (KOA) who underwent robot-assisted descending total knee arthroplasty(TKA) from January 2021 to July 2023,and they were divided into BRATKA group and HRATKA group according to use of robotic system. There were 40 patients in BRATKA group,including 16 males and 24 females,aged from 55 to 90 years old with an average of (64.3±7.0) years old;27 patients with grade Ⅲ and 13 patients with grade Ⅳ according to Kellgren-Lawrence(K-L);18 patients on the right side and 22 patients on the left side;the courses of disease ranged from 1 to 30 years with an average of (15.3±7.6) years;imported Brainlab Knee3 surgical robot assisted system was adopted. There were 53 patients in HRATKA group,including 18 males and 35 females,aged from 52 to 81 years old with an average of (64.4±8.5) years old;30 patients with grade Ⅲ and 23 patients with grade Ⅳ;21 patients on the right side and 32 patients on the left side;the courses of disease ranged from 1 to 32 years with an average of (16.4±7.9) years;HURWA surgical robot assisted system was adopted. Operation time,perioperative total blood loss,incision length and postoperative complications were compared between two groups. Deviation angle of hip-knee-ankle angle(HKAA) before operation and on the first day after operation was compared between two groups. Later tibal component (LTC),frontal femoral component (FFC),later femoral component (LFC) and frontal tibal component(FTC) at 1 day after on the first day after operation was compared between two groups. Knee Society score(KSS),visual analogue scale (VAS) and range of motion (ROM) of knee joint were compared between two groups before operation and on the 3rd and 90th day after operation.
Results Both groups were followed up for 11 to 18 months with an average of (14.4±2.1) months,and the wounds of all patients healed well. Operation time and incision length of BRATKA group were (132.1±34.6) min and (12.9±1.9) cm,while (94.1±10.8) min and (14.8±2.1) cm in HRATKA group,respectively,and the differences between two groups were statistically significant(P＜0.05). There were no significant difference in perioperative total blood loss and preoperative deviation angle of HKAA between two groups(P＞0.05). Deviation angle of HKAA,FFC angle and LFC angle in BRATKA group were (1.90±0.91) °,(87.90±1.51) ° and(9.00±3.2) °,respectively;while (0.93±1.04) °,(89.03±0.96) ° and (7.63±0.59) ° in HRATKA group,respectively,and the differences between two groups were statistically significant (P＜0.05). There were no significant differences in FTC and LTC between two groups(P＞0.05). There were no significant differences in VAS of knee rest and exercise,KSS score and ROM of knee joint between two groups before operation and 3 days and 90 days after operation(P＞0.05). There was no significant difference in complications between two groups (P＞0.05).
Conclusion Postoperative imaging of two robot systems showed good lower limb force line. The domestic HRATKA group had better LFC,FFC angle and HKA deviation angle than the imported BRATKA group,but there were no significant difference in postoperative knee function and pain relief. |
| KEYWORDS:Knee osteoarthritis Surgical robot Total knee arthroplasty |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王洪平,王明友,唐茁栋,陶崎峰,兰玉平.两款不同手术机器人辅助全膝关节置换的回顾性研究[J].中国骨伤,2024,37(9):870~877 |
| 英文格式: | WANG Hong-ping,WANG Ming-you,TANG Zhuo-dong,TAO Qi-feng,LAN Yu-ping.A retrospective study on two different surgical robots to assist total knee arthroplasty[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(9):870~877 |
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