Wang Yang, Ji Baochao, Chen Yongjie, Li Guoqing
Department of Joint Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi Xinjiang, 830054, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2022 May 15;36(5):555-560. doi: 10.7507/1002-1892.202109054.
To investigate the short-term effectiveness of MAKO robot assisted complex total hip arthroplasty (THA).
The clinical data of 15 patients (17 hips) underwent MAKO robot assisted complex THA between May 2020 and June 2021 were analyzed retrospectively. There were 5 males and 10 females with the age ranged from 19 to 70 years (median, 49 years), included 9 cases (9 hips) of developmental dysplasia of the hip (Crowe type Ⅱ in 5 hips, type Ⅲ in 1 hip, and type Ⅳ in 3 hips), 1 case (2 hips) of rheumatoid arthritis, 2 cases (3 hips) of ankylosing spondylitis, 3 cases (3 hips) of secondary arthritis with a history of acetabular fracture and internal fixation. The acetabular cup abduction angle and anteversion angle were measured at 3 months after operation, and compared with those measured by MAKO robot system before and immediately after operation. The femoral offset and leg length discrepancy (LLD) were measured at 3 months after operation, which were compared with those before operation. Harris hip score (HHS) and visual analogue scale (VAS) score were used to evaluate hip function before operation and at 3 months after operation.
All 15 patients (17 hips) completed the operation successfully. The operation time was 75-175 minutes, with an average of 116.3 minutes; the intraoperative blood loss was 100-800 mL, with an average of 381.3 mL. Two patients were not included in the statistics because of intraoperative and postoperative complications, the remaining 13 patients (15 hips) had no serious complication such as vascular and nerve injuries, and 3 patients had intermuscular vein thrombosis. The 13 patients (15 hips) were followed up 3-15 months, with an average of 8 months. At last follow-up, the position of prosthesis did not change and there was no signs of loosening. There was no significant difference in acetabular abduction angle at immediate and 3 months after operation when compared with preoperative one ( >0.05), and the acetabular anteversion angle was significantly lower than that before operation ( <0.05). There was no significant difference in acetabular abduction angle and anteversion angle between at immediate and 3 months after operation ( >0.05). The LLD, offset, HHS score, and VAS score were significantly improved at 3 months after operation when compared with preoperative ones ( <0.05).
MAKO robot assisted complex THA can achieve good short-term effectiveness, improve the hip range of motion, reduce the length difference between bilateral lower limbs, and improve the quality of patients' life.
探讨MAKO机器人辅助复杂全髋关节置换术(THA)的短期疗效。
回顾性分析2020年5月至2021年6月期间接受MAKO机器人辅助复杂THA的15例患者(17髋)的临床资料。其中男性5例,女性10例,年龄19~70岁(中位数49岁),包括髋关节发育不良9例(9髋,其中CroweⅡ型5髋、Ⅲ型1髋、Ⅳ型3髋),类风湿关节炎1例(2髋),强直性脊柱炎2例(3髋),髋臼骨折内固定术后继发关节炎3例(3髋)。于术后3个月测量髋臼杯外展角和前倾角,并与MAKO机器人系统术前及术后即刻测量值进行比较。于术后3个月测量股骨偏心距和双下肢长度差(LLD),并与术前进行比较。采用Harris髋关节评分(HHS)和视觉模拟评分(VAS)对术前及术后3个月的髋关节功能进行评价。
15例患者(17髋)均成功完成手术。手术时间75~175分钟,平均116.3分钟;术中出血量100~800毫升,平均381.3毫升。2例患者因术中及术后并发症未纳入统计,其余13例患者(15髋)未发生血管、神经损伤等严重并发症,3例患者发生肌间静脉血栓形成。13例患者(15髋)随访3~15个月,平均8个月。末次随访时,假体位置无改变,无松动迹象。术后即刻及术后3个月髋臼外展角与术前比较差异无统计学意义(>0.05),髋臼前倾角明显低于术前(<0.05)。术后即刻与术后3个月髋臼外展角和前倾角比较差异无统计学意义(>0.05)。术后3个月时LLD、偏心距、HHS评分及VAS评分与术前比较均明显改善(<0.05)。
MAKO机器人辅助复杂THA可取得良好的短期疗效,改善髋关节活动范围,减少双下肢长度差异,提高患者生活质量。