Sun Maolin, Yang Liu, Guo Lin, He Rui
Center for Joint Surgery, the First Affiliated Hospital (Southwest Hospital), Army Medical University, Chongqing, 400038, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021 Jul 15;35(7):807-812. doi: 10.7507/1002-1892.202102043.
To investigate the improvement of femoral rotation alignment in total knee arthroplasty (TKA) by robotic-arm assisted positioning and osteotomy and its short-term effectiveness.
Between June 2020 and November 2020, 60 patients (60 knees) with advanced osteoarthritis of the knee, who met the selection criteria, were selected as the study subjects. Patients were randomly divided into two groups according to the random number table method, with 30 patients in each group. Patients were treated with robotic-arm assisted TKA (RATKA) in trial group, and with conventional TKA in control group. There was no significant difference in gender, age, side and course of osteoarthritis, body mass index, and the preoperative hip-knee-ankle angle (HKA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), posterior condylar angle (PCA), knee society score-knee (KSS-K) and KSS-function (KSS-F) scores between the two groups ( >0.05). The clinical (KSS-K, KSS-F scores) and imaging (HKA, LDFA, MPTA, PCA) evaluation indexes of the knee joints were compared between the two groups at 3 months after operation.
All patients were successfully operated. The incisions in the two groups healed by first intention, with no complications related to the operation. Patients in the two groups were followed up 3-6 months, with an average of 3.9 months. KSS-K and KSS-F scores of the two groups at 3 months after operation were significantly higher than those before operation ( <0.05), but there was no significant difference between the two groups ( >0.05). X-ray re-examination showed that the prosthesis was in good position, and no prosthesis loosening or sinking occurred. HKA, MPTA, and PCA significantly improved in both groups at 3 months after operation ( <0.05) except LDFA. There was no significant difference in HKA, LDFA, and MPTA between the two groups ( >0.05). PCA in trial group was significantly smaller than that in control group ( =2.635, =0.010).
RATKA can not only correct knee deformity, relieve pain, improve the quality of life, but also achieve the goal of restoring accurate femoral rotation alignment. There was no adverse event after short-term follow-up and the effectiveness was satisfactory.
探讨机器人手臂辅助定位及截骨在全膝关节置换术(TKA)中对股骨旋转对线的改善情况及其短期疗效。
选取2020年6月至2020年11月符合入选标准的60例膝关节晚期骨关节炎患者(60膝)作为研究对象。根据随机数字表法将患者随机分为两组,每组30例。试验组采用机器人手臂辅助全膝关节置换术(RATKA)治疗,对照组采用传统全膝关节置换术治疗。两组患者在性别、年龄、患侧及骨关节炎病程、体重指数、术前髋-膝-踝角(HKA)、股骨远端外侧角(LDFA)、胫骨近端内侧角(MPTA)、后髁角(PCA)、膝关节协会评分-膝关节(KSS-K)和KSS-功能(KSS-F)评分方面比较,差异均无统计学意义(>0.05)。比较两组患者术后3个月时膝关节的临床(KSS-K、KSS-F评分)和影像学(HKA、LDFA、MPTA、PCA)评估指标。
所有患者均手术成功。两组切口均一期愈合,无手术相关并发症。两组患者随访3~6个月,平均3.9个月。两组患者术后3个月时KSS-K和KSS-F评分均显著高于术前(<0.05),但两组间比较差异无统计学意义(>0.05)。X线复查显示假体位置良好,无假体松动或下沉。术后3个月时,除LDFA外,两组患者的HKA、MPTA和PCA均显著改善(<0.05)。两组患者的HKA、LDFA和MPTA比较,差异无统计学意义(>0.05)。试验组的PCA显著小于对照组(=2.635,=0.010)。
RATKA不仅能纠正膝关节畸形、缓解疼痛、提高生活质量,还能实现恢复准确股骨旋转对线的目标。短期随访无不良事件发生,疗效满意。