Luo Jin, Yan Ya-Jing, Wang Xiao-Dong, Long Xu-Dong, Lan Hai, Li Kai-Nan
Department of Orthopaedics, Affiliated Hospital of Chengdu University, Chengdu, China.
Orthop Surg. 2020 Jun;12(3):784-791. doi: 10.1111/os.12678. Epub 2020 May 11.
To investigate the safety and superiority of robot-assisted femoral head drilling decompression in the treatment of femoral head necrosis.
A total of 63 patients who underwent borehole decompression of the femoral head in our hospital from January 2016 to March 2019 were recruited. Patients were divided into two groups for comparison according to surgical methods. In the robot-assisted surgery group, there were 30 cases with 41 femoral heads. The conventional group had 33 cases and 46 femoral heads. All patients signed the consent form before the operation. The follow-up time was 6 months. The incision lengths, operation times, intraoperative blood loss, intraoperative fluoroscopies, guide needle punctures, postoperative Harris scores, and postoperative complications of the two groups were compared.
The incision length of the robot surgery group was 5.16 ± 0.41 cm, while that of the traditional surgery group was 7.42 ± 0.50 cm. The operation time of the robot surgery group was 46.99 ± 4.94 min, while that of the traditional surgery group was 55.01 ± 6.19 min. The fluoroscopy frequency of the robot surgery group was 10.50 ± 1.78 times, while that of the traditional surgery group was 17.91 ± 2.20 times. The intraoperative blood loss in the robotic surgery group was 20.62 ± 2.52 mL, while that in the conventional surgery group was 52.72 ± 3.39 mL. In the robot operation group, each femoral head guide needle was punctured three times, and the puncture was successful one time. The number of guided needle punctures in the traditional group was 8.02 ± 1.73. The difference between the two groups was statistically significant (P < 0.05). The Harris score was 69.53 ± 7.51 in the robot surgery group and 68.38 ± 7.26 in the traditional surgery group one month after surgery, 78.52 ± 6.49 in the robot surgery group and 76.41 ± 7.95 in the traditional surgery group three months after surgery, and 83.32 ± 8.62 in the robot surgery group and 81.74 ± 6.20 in the traditional surgery group six months after surgery. There was no significant difference between the two groups (P > 0.05). In the traditional group, there was one case of incision infection and one case of femoral head collapse during follow-up. In the robot group, there were no complications, such as incision infection and deep vein thrombosis. No collapse of the femoral head was found in the robot group during follow-up.
The positioning system of the orthopaedic robot is an ideal method for the treatment of femoral head necrosis. This method has the advantages of simple operation, accurate drilling, a short operation time, less surgical trauma, less radioactivity, and good recovery of hip joint function.
探讨机器人辅助股骨头钻孔减压治疗股骨头坏死的安全性及优越性。
选取2016年1月至2019年3月在我院行股骨头钻孔减压术的63例患者。根据手术方式将患者分为两组进行对比。机器人辅助手术组30例，共41个股骨头；传统手术组33例，共46个股骨头。所有患者术前均签署知情同意书。随访时间为6个月。比较两组患者的切口长度、手术时间、术中出血量、术中透视次数、导针穿刺次数、术后Harris评分及术后并发症。
机器人手术组切口长度为（5.16±0.41）cm，传统手术组为（7.42±0.50）cm。机器人手术组手术时间为（46.99±4.94）min，传统手术组为（55.01±6.19）min。机器人手术组透视次数为（10.50±1.78）次，传统手术组为（17.91±2.20）次。机器人手术组术中出血量为（20.62±2.52）mL，传统手术组为（52.72±3.39）mL。机器人手术组每个股骨头导针穿刺3次，1次成功；传统组导针穿刺次数为（8.02±1.73）次。两组差异有统计学意义（P＜0.05）。术后1个月，机器人手术组Harris评分为（69.53±7.51）分，传统手术组为（68.38±7.26）分；术后3个月，机器人手术组为（78.52±6.49）分，传统手术组为（76.41±7.95）分；术后6个月，机器人手术组为（83.32±8.62）分，传统手术组为（81.74±6.20）分。两组差异无统计学意义（P＞0.05）。传统组随访期间有1例切口感染、1例股骨头塌陷；机器人组无切口感染、深静脉血栓等并发症，随访期间未发现股骨头塌陷。
骨科机器人定位系统是治疗股骨头坏死的理想方法。该方法操作简单、钻孔精确、手术时间短、手术创伤小、放射性小、髋关节功能恢复良好。
