Medical School of Chinese PLA, No. 28 Fuxing Road, Haidian District, Beijing, China.
Senior Department of Orthopedics, the Forth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100853, China.
J Orthop Surg Res. 2022 Jul 30;17(1):368. doi: 10.1186/s13018-022-03263-6.
The objective of this study was to evaluate the accuracy of acetabular cup positioning in the obese patients when using robotic-assisted technology during total hip arthroplasty (THA).
Data were retrospectively collected from patients who underwent primary (THA) with a body mass index (BMI) ≥ 28 kg/m and ≥ 1 year of follow-up between January 2018 and December 2019. Their demographics, diagnosis, acetabular cup positioning, American Society of Anesthesiologists (ASA) score, Harris Hip Score (HHS), and Forgotten Joint Score (FJS) at the final follow-up were recorded for analysis.
There were no statistically significant differences between the two groups in height, weight, BMI, ASA score, or preoperative Harris Hip Score (HHS). Also, there was no difference in inclination angle between the two groups (R-THA: 41.29° ± 3.04°; manual THA (M-THA): 40.47° ± 5.46°; P = 0.312). However, the mean anteversion angle was greater in the R-THA group (20.71° ± 1.98° vs. 19.08° ± 4.04°; P < 0.001). Compared to M-THA, R-THA more frequently achieved an acetabular cup angle within 5° of the target (anteversion, 98.1% vs. 78.1% P = 0.001; inclination, 88.5% vs. 53.1%, P < 0.001). The R-THA group was more advantageous in restoring the hip center of rotation (COR) and leg length difference (LLD). There was no statistical difference in postoperative HHS (P = 0.404) or FJS (P = 0.497) between the two groups.
Compared to manual technique, robotic-assisted technique provided more precise acetabular cup positioning and better leg length restoration for obese patients. The robotic-assisted technique was more advantageous in recovering the center of rotation position and achieved a higher proportion of the acetabular cup placed in the target safety zone. Further studies are needed to confirm the clinical outcomes of surgeries in obese patients using robotic-assisted technology.
本研究旨在评估肥胖患者在全髋关节置换术（THA）中使用机器人辅助技术时髋臼杯定位的准确性。
回顾性收集 2018 年 1 月至 2019 年 12 月期间 BMI≥28kg/m 和随访≥1 年的初次（THA）患者的数据。分析他们的人口统计学、诊断、髋臼杯定位、美国麻醉医师协会（ASA）评分、髋关节 Harris 评分（HHS）和最终随访时的遗忘关节评分（FJS）。
两组患者在身高、体重、BMI、ASA 评分或术前髋关节 Harris 评分（HHS）方面无统计学差异。两组髋臼杯倾斜角也无差异（R-THA：41.29°±3.04°；手动 THA（M-THA）：40.47°±5.46°；P=0.312）。然而，R-THA 组的平均前倾角更大（20.71°±1.98° vs. 19.08°±4.04°；P<0.001）。与 M-THA 相比，R-THA 更频繁地使髋臼杯角度在目标范围内 5°以内（前倾角，98.1% vs. 78.1%，P=0.001；倾斜角，88.5% vs. 53.1%，P<0.001）。R-THA 组在恢复髋关节旋转中心（COR）和下肢长度差异（LLD）方面更具优势。两组术后 HHS（P=0.404）或 FJS（P=0.497）无统计学差异。
与手动技术相比，机器人辅助技术为肥胖患者提供了更精确的髋臼杯定位和更好的下肢长度恢复。机器人辅助技术在恢复旋转中心位置方面更具优势，并且能够将更高比例的髋臼杯放置在目标安全区域内。需要进一步的研究来确认肥胖患者使用机器人辅助技术进行手术的临床结果。
