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半主动机器人手臂系统与初次全膝关节置换术中的患者特异性器械:疗效与准确性

Semiactive robotic-arm system versus patient-specific instrumentation in primary total knee arthroplasty: Efficacy and accuracy.

作者信息

He Rui, Sun Maolin, Xiong Ran, Yang Junjun, Guo Lin, Yang Liu

机构信息

Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.

Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.

出版信息

Asian J Surg. 2023 Feb;46(2):742-750. doi: 10.1016/j.asjsur.2022.06.151. Epub 2022 Jul 11.

Abstract

OBJECTIVE

To compare the difference in efficacy and accuracy during total knee arthroplasty (TKA) among robotic-arm system, patient-specific instrumentation (PSI) and conventional TKA (COTKA).

METHODS

Retrospective analysis of 90 advanced knee osteoarthritis (OA) patients in our hospital between June 2019 and December 2020 was conducted. Patients were divided into robotic arm-assisted (RA)TKA (group A), PSITKA (group B) and COTKA (group C), 30 cases in each group. The operation time, intraoperative bleeding, and length of hospital stay were counted. Imaging data of hip-knee-ankle angle (HKA), posterior condylar angle (PCA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), and sagittal tibial component angle (sTCA) were statistically analyzed. The postoperative recovery of the patients was evaluated by Knee Society Score (KSS) and the Western Ontario Mac Master University Index Score (WOMAC).

RESULTS

Group A had the least intraoperative bleeding. For operation time, group A was the longest compared with group B and group C (P < 0.05), while group B was longer than group C (P < 0.05). There was no significant difference in HKA, LDFA, and MPTA among the three groups, and the lower limb alignments were all restored to the neutral position. PCA of group A and B were both smaller than that of group C and closer to 0° (P < 0.05), but the difference between group A and B was not statistically significant. The sTCA in group A was significantly better than group B, and group B was significantly better than group C (P < 0.05). There were no significant differences in function scores among the three groups.

CONCLUSION

Compared to the PSI and CO, RA is more minimally invasive and more accurate in radiographic results.

摘要

目的

比较机器人手臂系统、患者特异性器械(PSI)和传统全膝关节置换术(COTKA)在全膝关节置换术(TKA)过程中的疗效和准确性差异。

方法

对我院2019年6月至2020年12月期间的90例晚期膝关节骨关节炎(OA)患者进行回顾性分析。患者分为机器人手臂辅助(RA)TKA组(A组)、PSI-TKA组(B组)和COTKA组(C组),每组30例。统计手术时间、术中出血量和住院时间。对髋-膝-踝角(HKA)、后髁角(PCA)、股骨远端外侧角(LDFA)、胫骨近端内侧角(MPTA)和胫骨矢状面组件角(sTCA)的影像学数据进行统计分析。采用膝关节协会评分(KSS)和西安大略麦克马斯特大学指数评分(WOMAC)评估患者术后恢复情况。

结果

A组术中出血量最少。手术时间方面,A组比B组和C组最长(P<0.05),而B组比C组长(P<0.05)。三组间HKA、LDFA和MPTA差异无统计学意义,下肢力线均恢复至中立位。A组和B组的PCA均小于C组且更接近0°(P<0.05),但A组和B组之间差异无统计学意义。A组的sTCA明显优于B组,B组明显优于C组(P<0.05)。三组功能评分差异无统计学意义。

结论

与PSI和CO相比,RA的微创性更强,影像学结果更准确。

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