Chai Wei, Kong Xiangpeng, Yang Minzhi, Puah Ken Lee, Tang Peifu, Chen Jiying
Department of Orthopedics, Chinese PLA General Hospital, Beijing, People's Republic of China.
Medical College, Nankai University, Tianjin, People's Republic of China.
Ther Clin Risk Manag. 2020 May 4;16:357-368. doi: 10.2147/TCRM.S246565. eCollection 2020.
Conversion of arthrodesed hips to total hip arthroplasty (THA) remains technically demanding. This study aims to evaluate the safety and efficacy of robot-assisted THA in arthrodesed hips.
We retrospectively analyzed 45 ankylosing spondylitis patients with hip arthrodesis in the Chinese PLA General Hospital between August 2018 and August 2019. All surgeries were carried out by one single surgeon. The patients were followed at 3 months after surgery. Gender, body mass index, angle of hip arthrodesis, operating time, intraoperative fluoroscopic times, postoperative length of hospitalization, cup positioning, postoperative leg length discrepancy, offset discrepancy, intraoperative and postoperative complications, and postoperative Harris Hip Score were collected for all patients.
Twenty-two patients (35 hips) who underwent robot-assisted THA and 23 patients (37 hips) who underwent manual THA were enrolled in this study. There were no significant differences in demographics and arthrodesed angles between the two groups. The fluoroscopic times during manual THA were significantly higher than those during robot-assisted THA (2.16±1.61 vs 0.47±0.61, respectively, =0.000). In the robotic group, the percentage of acetabular cups within the safe zone was significantly greater than in the manual group (94.29% vs 67.56%, respectively, =0.042). For manual THA, the anteversions were significantly different between the left and right sides (21.14±7.86 vs 16.00±6.32, respectively, =0.042); however, no such significant difference was found in robot-assisted THA.
Compared with manual THA for arthrodesed hips, robot-assisted THA had significant advantages in improving the frequency of achieving cup positioning within the target zone with diminished radiation dose and no increase in operating time.
将融合的髋关节转换为全髋关节置换术(THA)在技术上仍然具有挑战性。本研究旨在评估机器人辅助THA在融合髋关节中的安全性和有效性。
我们回顾性分析了2018年8月至2019年8月在中国人民解放军总医院的45例强直性脊柱炎髋关节融合患者。所有手术均由同一位外科医生进行。患者在术后3个月进行随访。收集所有患者的性别、体重指数、髋关节融合角度、手术时间、术中透视次数、术后住院时间、髋臼杯位置、术后双下肢长度差异、偏心距差异、术中和术后并发症以及术后Harris髋关节评分。
本研究纳入了22例接受机器人辅助THA的患者(35髋)和23例接受人工THA的患者(37髋)。两组在人口统计学和融合角度方面无显著差异。人工THA术中透视次数显著高于机器人辅助THA(分别为2.16±1.61次和0.47±0.61次,P = 0.000)。机器人组髋臼杯在安全区内的百分比显著高于人工组(分别为94.29%和67.56%,P = 0.042)。对于人工THA,左右侧前倾角有显著差异(分别为21.14±7.86°和16.00±6.32°,P = 0.042);然而,在机器人辅助THA中未发现此类显著差异。
与人工THA治疗融合髋关节相比,机器人辅助THA在提高髋臼杯在目标区域内定位的频率、减少辐射剂量且不增加手术时间方面具有显著优势。