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全膝关节置换术机器人辅助技术的当前发展:全面概述

Current developments in robotic assistance technology for total knee arthroplasty: a comprehensive overview.

作者信息

Zhang Hongli, Jiang Xing-An, Jin Bing-Chen, Zhang Hong-Hao, Liang Jun-Bo

机构信息

Department of Orthopedic, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China.

Department of Orthopedic, Taizhou Hospital of Zhejiang Province Affiliated to Zhejiang University, Taizhou, Zhejiang, China.

出版信息

J Orthop Surg Res. 2025 Jan 22;20(1):80. doi: 10.1186/s13018-025-05490-z.

Abstract

Knee arthritis is a common degenerative joint disease, usually with joint swelling, chronic pain, and dysfunction as the main clinical manifestations. At present, the conservative treatment for knee arthritis is mostly using anti-inflammatory and analgesic drugs, but the effect is mostly temporary, and can not prevent its progress and surgery is usually the last treatment method. Total knee arthroplasty, also known as TKA, is one of the most effective treatments for osteoarthritis of the knee that has progressed to the end stage. The inevitable human factor in conventional total knee arthroplasty (TKA) frequently results in poor positioning of the prosthesis during the reconstruction of the lower limb's biomechanical axis. This can lead to severe postoperative pain, accelerated wear of the prosthesis, early loosening, and other problems in the affected knee, which has always been a primary concern for orthopaedic surgeons. Over the course of the past few years, China has gradually begun to develop joint robots. The idea is to plan the surgical plan based on the anatomical structure of the affected limb before the operation, and then to use a mechanical arm and a visual system to assist in the implantation of the prosthesis while the operation is being performed. The treatment costs of robot-assisted technology, on the other hand, vary greatly, and there is still a relatively small amount of high-quality evidence on clinical efficacy. This is because the field of robotic-assisted technology is a relatively new one that has gradually developed over the past few years. In order to provide a fundamental reference for the application value of new treatment methods for advanced knee osteoarthritis, it is necessary to conduct an analysis of the current status of the application of joint robots, as well as the technical advantages and disadvantages that they bring.This narrative study delineates the historical context and current clinical application of robots in knee replacement surgery. An examination of the advantages and disadvantages of RATKA in comparison to TKA offers insights on the prospective application value of the technology.Clinical trial number: Not applicable.

摘要

膝关节骨关节炎是一种常见的退行性关节疾病,通常以关节肿胀、慢性疼痛和功能障碍为主要临床表现。目前,膝关节骨关节炎的保守治疗大多采用抗炎镇痛药,但效果多为暂时的,无法阻止其病情进展,而手术通常是最后的治疗手段。全膝关节置换术(TKA)是膝关节骨关节炎发展到终末期最有效的治疗方法之一。传统全膝关节置换术(TKA)中不可避免的人为因素常常导致在重建下肢生物力学轴线时假体定位不佳。这可能导致患膝术后疼痛剧烈、假体磨损加速、早期松动等问题,一直是骨科医生主要关注的问题。在过去几年中,中国已逐渐开始研发关节机器人。其理念是在手术前根据患侧肢体的解剖结构规划手术方案,然后在手术过程中使用机械臂和视觉系统辅助假体植入。另一方面,机器人辅助技术的治疗费用差异很大,而且关于临床疗效的高质量证据仍然相对较少。这是因为机器人辅助技术领域是一个在过去几年中逐渐发展起来的相对较新的领域。为了为晚期膝关节骨关节炎新治疗方法的应用价值提供基本参考,有必要对关节机器人的应用现状及其带来的技术优缺点进行分析。本叙述性研究阐述了机器人在膝关节置换手术中的历史背景和当前临床应用情况。通过对比机器人辅助全膝关节置换术(RATKA)与TKA的优缺点,对该技术的未来应用价值提供见解。临床试验编号:不适用。

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