Zhao Y C, Qu W Q, Zhang S D
Department of Osteoarthropathy, Yantaishan Hospital, Yantai 264001, China.
Zhonghua Wai Ke Za Zhi. 2018 Nov 1;56(11):849-853. doi: 10.3760/cma.j.issn.0529-5815.2018.11.011.
To evaluate the effects of orthopedic robot navigation system used in core decompression combined with bone graft surgery for osteonecrosis of the femoral head (ONFH). A retrospective analysis was performed on 9 patients (16 hips) underwent core decompression surgery combined with bone graft treatment for early ONFH in ARCO Ⅱat Department of Osteoarthropathy, Yantaishan Hospital from June 2016 to February 2018.There were 7 males and 2 females, aged 44.6 years (range: 28-60 years). All surgery procedures were completed by the same doctor under the navigation of orthopedic surgery robot using the specific designed tools. The preoperative and postoperative Harris Hip Score and visual analogue score were compared and the time of intraoperative X-ray fluoroscopy was recorded. The mean follow-up period was (12.7±3.5)months (range: 6-18 months). Four cases of treatment failure were observed in 16 hips at the last follow-up and the hip survival rate was 12/16.In stage ARCO Ⅱa, Ⅱb and Ⅱc, the survival rate was 1/1, 2/2, and 9/13.The Harris Hip Score (88.3±1.9 .70.0±3.8, =16.81, =0.000) and visual analogue score (3.7±0.7 . 0.9±0.6, =13.49, =0.000) were improved significantly at the last follow-up compared with preoperative value. The total times of intraoperative X-ray fluoroscopy were 15.9±2.5, including 5.8±1.2 before the insertion of the guiding wire and 10.1±1.7 after the insertion of the guiding wire. The domestic orthopedic surgery robot can be applied successfully in the core decompression combined with bone graft surgery for ONFH . It is less invasive with less fluoroscopy time and better bone graft effects.
评估骨科机器人导航系统在股骨头坏死(ONFH)髓芯减压联合植骨手术中的应用效果。对2016年6月至2018年2月在烟台山医院骨关节科接受ARCOⅡ期早期ONFH髓芯减压联合植骨治疗的9例患者(16髋)进行回顾性分析。其中男性7例,女性2例,年龄44.6岁(范围:28 - 60岁)。所有手术均由同一名医生在骨科手术机器人导航下使用特定设计工具完成。比较术前和术后Harris髋关节评分及视觉模拟评分,并记录术中X线透视时间。平均随访时间为(12.7±3.5)个月(范围:6 - 18个月)。末次随访时,16髋中有4例治疗失败,髋关节生存率为12/16。在ARCOⅡa、Ⅱb和Ⅱc期,生存率分别为1/1、2/2和9/13。末次随访时Harris髋关节评分(88.3±1.9比70.0±3.8,t = 16.81,P = 0.000)和视觉模拟评分(3.7±0.7比0.9±0.6,t = 13.49,P = 0.000)较术前明显改善。术中X线透视总次数为15.9±2.5次,其中导针插入前5.8±1.2次,导针插入后10.1±1.7次。国产骨科手术机器人可成功应用于ONFH髓芯减压联合植骨手术,具有创伤小、透视时间少、植骨效果好等优点。