Meng Chen, Xu Yongqing, Shi Rongmao, Pu Luqiao, Ji Jian'an, Yao Xingyou, Zhou Xizong, Li Chuan
Department of Orthopedics, 920th Hospital of the Joint Logistics Support Force of Chinese PLA, Kunming Yunnan, 650000, P. R. China.
Graduate School, Kunming Medical University, Kunming Yunnan, 650000, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2025 Jan 15;39(1):5-12. doi: 10.7507/1002-1892.202408061.
To evaluate the early effectiveness of navigation-free robot-assisted total knee arthroplasty (TKA) compared to traditional TKA in the treatment of knee osteoarthritis combined with extra-articular deformities.
The clinical data of 30 patients with knee osteoarthritis combined with extra-articular deformities who met the selection criteria between June 2019 and January 2024 were retrospectively analyzed. Fifteen patients underwent CORI navigation-free robot-assisted TKA and intra-articular osteotomy (robot group) and 15 patients underwent traditional TKA and intra-articular osteotomy (traditional group). There was no significant difference in age, gender, body mass index, affected knee side, extra-articular deformity angle, deformity position, deformity type, and preoperative knee range of motion, American Knee Society (KSS) knee score and KSS function score, and lower limb alignment deviation between the two groups ( >0.05). The operation time, intraoperative blood loss, and complications of the two groups were recorded and compared. The knee range of motion and lower limb alignment deviation were recorded before operation and at 6 months after operation, and the knee joint function was evaluated by KSS knee score and function score.
There was no significant difference in operation time between the two groups ( >0.05); the intraoperative blood loss in the robot group was significantly less than that in the traditional group ( <0.05). Patients in both groups were followed up 6-12 months, with an average of 8.7 months. The incisions of all patients healed well, and there was no postoperative complication such as thrombosis or infection. At 6 months after operation, X-ray examination showed that the position of the prosthesis was good in both groups, and there was no loosening or dislocation of the prosthesis. The knee joint range of motion, the lower limb alignment deviation, and the KSS knee score and KSS function score significantly improved in both groups ( <0.05) compared to preoperative ones. The changes of lower limb alignment deviation and KSS function score between pre- and post-operation in the robot group were significantly better than those in the traditional group ( <0.05), while the changes of other indicators between pre- and post-operation in the two groups were not significant ( >0.05).
Compared to traditional TKA, navigation-free robot-assisted TKA for knee osteoarthritis with extra-articular deformities results in less intraoperative blood loss, more precise reconstruction of lower limb alignment, and better early effectiveness. However, long-term effectiveness require further investigation.
评估无导航机器人辅助全膝关节置换术（TKA）与传统TKA治疗膝关节骨关节炎合并关节外畸形的早期疗效。
回顾性分析2019年6月至2024年1月期间30例符合入选标准的膝关节骨关节炎合并关节外畸形患者的临床资料。15例患者接受CORI无导航机器人辅助TKA及关节内截骨术（机器人组），15例患者接受传统TKA及关节内截骨术（传统组）。两组患者在年龄、性别、体重指数、患侧膝关节、关节外畸形角度、畸形位置、畸形类型以及术前膝关节活动范围、美国膝关节协会（KSS）膝关节评分和KSS功能评分、下肢对线偏差方面差异均无统计学意义（P>0.05）。记录并比较两组患者的手术时间、术中出血量及并发症情况。记录术前及术后6个月时膝关节活动范围和下肢对线偏差，并采用KSS膝关节评分和功能评分评估膝关节功能。
两组患者手术时间差异无统计学意义（P>0.05）；机器人组术中出血量显著少于传统组（P<0.05）。两组患者均随访6～12个月，平均8.7个月。所有患者切口愈合良好，未出现血栓形成、感染等术后并发症。术后6个月X线检查显示两组假体位置良好，无假体松动或脱位。两组患者术后膝关节活动范围、下肢对线偏差以及KSS膝关节评分和KSS功能评分均较术前显著改善（P<0.05）。机器人组术前、术后下肢对线偏差及KSS功能评分的变化明显优于传统组（P<0.05），而两组其他指标术前、术后变化差异无统计学意义（P>0.05）。
与传统TKA相比，无导航机器人辅助TKA治疗膝关节骨关节炎合并关节外畸形术中出血量更少，下肢对线重建更精确，早期疗效更佳。然而，长期疗效仍需进一步研究。
