Hold Mara, Windhagen Henning, Tuecking Lars-Rene
Orthopädische Klinik der Medizinischen Hochschule Hannover im Diakovere Annastift, Anna-von-Borries-Str, 30625, Hannover, Deutschland.
Orthopadie (Heidelb). 2025 Jun;54(6):457-465. doi: 10.1007/s00132-025-04653-4. Epub 2025 Apr 28.
At 0.2% of all knee replacements implanted in Germany, patellofemoral joint arthroplasty (PFA) account for only a small proportion. However, the potential in the population appears to be significantly greater. In recent years, several robotic-assisted surgical procedures have been developed to increase precision in the implantation of endoprostheses. MAKO® SYSTEM: At present, the Mako® system from Stryker is the only system that can implant an isolated patellofemoral joint replacement robotically. It can be used to analyze and adequately address complex anatomies such as trochlear dysplasia. The system provides support by simulating the positioning of the prosthesis and the exact execution of the plan by aligning the saw or reamer with haptic feedback.
Studies on robotic-assisted PFA are rare but indicate improved precision with a robotic-assisted procedure. Despite that, an improved clinical and radiological outcome could not be demonstrated in a comparative study.
A cost-benefit analysis should be discussed here, as should the necessary learning curve. In principle, robotic-assisted implantation of PFA appears to be a promising procedure. However, a superiority of this procedure over conventional methods cannot be postulated at the present time.
在德国植入的所有膝关节置换手术中，髌股关节置换术（PFA）仅占0.2%，占比很小。然而，该手术在人群中的潜力似乎要大得多。近年来，已经开发出几种机器人辅助手术程序，以提高假体植入的精度。
MAKO®系统：目前，史赛克公司的MAKO®系统是唯一能够通过机器人植入孤立髌股关节置换假体的系统。它可用于分析和妥善处理复杂的解剖结构，如滑车发育不良。该系统通过模拟假体定位并通过将锯或铰刀与触觉反馈对齐来精确执行计划，从而提供支持。
关于机器人辅助PFA的研究很少，但表明机器人辅助手术提高了精度。尽管如此，但在一项比较研究中，并未证明其临床和放射学结果得到改善。
这里应讨论成本效益分析以及必要的学习曲线。原则上，机器人辅助植入PFA似乎是一种有前景的手术。然而，目前尚不能假定该手术优于传统方法。
