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Mako 机器人辅助全膝关节置换术与传统人工全膝关节置换术治疗单纯单侧全膝关节置换术的疗效和安全性比较:一项单中心回顾性分析。

Comparison of the efficacy and safety of MAKO robot-assisted total knee arthroplasty versus conventional manual total knee arthroplasty in uncomplicated unilateral total knee arthroplasty a single-centre retrospective analysis.

机构信息

Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China.

Department of Orthopedic Surgery, Shanghai Guanghua Hospital of Integrative Medicine, Shanghai, People's Republic of China.

出版信息

Int Orthop. 2024 Sep;48(9):2351-2358. doi: 10.1007/s00264-024-06234-0. Epub 2024 Jun 14.

Abstract

PURPOSE

To compare the efficacy and safety of MAKO robot-assisted total knee arthroplasty (MA-TKA) with conventional manual total knee arthroplasty (CM-TKA) in patients with end-stage knee osteoarthritis (KOA) during the early postoperative period.

METHOD

A retrospective analysis was conducted on 22 patients with KOA who underwent MA-TKA and 26 patients who underwent CM-TKA from April 2023 to July 2023. Hip-knee-ankle angle (HKA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), American Knee Society Score (AKSS), Forgotten Joint Score-12 (FJS-12), visual analogue scale (VAS), and postoperative complications were recorded and compared between the two groups.

RESULT

Both groups successfully completed the surgeries. In terms of radiographic parameters, postoperative one month LDFA and HKA in the MA-TKA group were significantly lower than those in the CM-TKA group (P < 0.05). At the one month follow-up, 19 patients (86.4%) in the MA-TKA group had an HKA less than 3°, compared to 20 patients (76.9%) in the CM-TKA group. Clinically, VAS scores at 24 h, 48 h, and 72 h postoperatively were lower in the MA-TKA group both at rest and during activity. At one month and three months postoperatively, AKSS Function Scores and FJS-12 scores in the MA-TKA group were significantly higher than those in the CM-TKA group (P < 0.05). Regarding postoperative complications, no complications occurred in the MA-TKA group, while one patient in the CM-TKA group experienced postoperative knee stiffness, which resolved after physical therapy, with no statistically significant difference (P > 0.05).

CONCLUSION

Compared with conventional manual total knee arthroplasty, MAKO robot-assisted TKA demonstrates better short-term clinical efficacy, achieves better alignment planning, and maintains good safety.

摘要

目的

比较 Mako 机器人辅助全膝关节置换术(MA-TKA)与传统手动全膝关节置换术(CM-TKA)在膝关节骨关节炎(KOA)终末期患者术后早期的疗效和安全性。

方法

回顾性分析 2023 年 4 月至 7 月期间行 MA-TKA 的 22 例 KOA 患者和行 CM-TKA 的 26 例患者。记录并比较两组患者的髋膝踝角(HKA)、外侧远端股骨角(LDFA)、内侧近端胫骨角(MPTA)、美国膝关节协会评分(AKSS)、遗忘关节评分-12(FJS-12)、视觉模拟评分(VAS)和术后并发症。

结果

两组患者均顺利完成手术。在影像学参数方面,MA-TKA 组术后 1 个月 LDFA 和 HKA 显著低于 CM-TKA 组(P<0.05)。在 1 个月随访时,MA-TKA 组有 19 例(86.4%)患者 HKA<3°,CM-TKA 组有 20 例(76.9%)患者 HKA<3°。临床方面,MA-TKA 组患者术后 24、48、72 h 的静息和活动时 VAS 评分均较低。术后 1 个月和 3 个月,MA-TKA 组的 AKSS 功能评分和 FJS-12 评分均显著高于 CM-TKA 组(P<0.05)。在术后并发症方面,MA-TKA 组无并发症发生,CM-TKA 组 1 例患者出现术后膝关节僵硬,经物理治疗后缓解,两组间无统计学差异(P>0.05)。

结论

与传统手动全膝关节置换术相比,Mako 机器人辅助 TKA 具有更好的短期临床疗效,能实现更好的对线规划,并保持良好的安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac8c/11347482/10744e34e9df/264_2024_6234_Fig1_HTML.jpg

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