摘要
目的回顾性分析鸿鹄骨科手术机器人(简称机器人)辅助人工全膝关节置换术(total knee arthroplasty,TKA)近期疗效与学习曲线特征。方法纳入2020年10月至2021年2月在陆军军医大学第一附属医院关节外科因终末期膝骨关节炎接受TKA手术治疗患者共60例(60膝),分为机器人组(30例30膝)与传统组(30例30膝)。对比分析两组患者术前及术后3、6个月西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分、影像学测量指标、手术操作相关指标。对比机器人辅助TKA组学习曲线相关指标的变化趋势,比较处于学习曲线期间两组近期疗效的差异。结果机器人组术后3个月WOMAC评分总分优于传统组(P<0.05),术后6个月评分无统计学差异。机器人组术后HKA、FTC优于传统组(P<0.05);机器人组学习曲线为15例,15例之后手术时间等学习曲线指标显著降低(P<0.05);机器人组在学习曲线期,手术时间长于传统组(P<0.05);术中失血量、HKA、FTC优于传统组(P<0.05)。结论机器人辅助TKA学习曲线短,精准度高,能准确重建下肢力线,创伤较传统手术更小,术后早期临床评分更佳,同期手术耗时也相应延长。
Objective To retrospectively analyze the short-term efficacy and learning curve characteristics of SkyWalker orthopedic robot(hereinafter referred to as robot)assisted total knee arthroplasty(TKA).Methods A total of 60 patients(60 knees)who underwent TKA for end-stage knee osteoarthritis in our center from October 2020 to February 2021 were enrolled in this study.They were divided into the robotic group(30 knees)and conventional group(30 knees).The scores of Western Ontario and McMaster University Osteoarthritis Index(WOMAC),imaging indexes,and operation-related indexes before surgery and 3,6 months after surgery were studied and compared between the 2 groups.The learning curve-related indexes of the robot-assisted TKA group and conventional were compared;the short-term efficacy during the learning curve period between the 2 groups was compared.Results The total WOMAC score of the robotic group was better than that of the conventional group at 3 months after surgery(P<0.05),and there was no statistical difference in the score at 6 months after surgery.The postoperative hip-knee-ankle(HKA)angeland frontal tibia component(FTC)angle of the robotic group were better than those of the conventional group(P<0.05);the learning curve of the robotic group was 15 cases,and the learning curve indexes after 15 cases were significantly reduced(P<0.05);the operation time of the robotic group during the learning curve period was longer than the conventional group(P<0.05);intraoperative blood loss,HKA,FTC were better than the conventional group(P<0.05).Conclusion Robot-assisted TKA has a short learning curve,abtains high accuracy,and can accurately reconstruct the lower limb alignment.It is less traumatic than conventional TKA,better clinical scores in the early postoperative period,but it also requires longer operation time.
作者
何锐
孙茂淋
熊然
雷凯
杨君君
杨柳
HE Rui;SUN Maolin;XIONG Ran;LEI Kai;YANG Junjun;YANG Liu(Chongqing Key Laboratory of Precision Medicine of Joint Surgery,Center for Joint Surgery,First Affiliated Hospital,Army Medical University(Third Military Medical University),Chongqing,400038,China)
出处
《陆军军医大学学报》
CAS
CSCD
北大核心
2022年第5期476-483,共8页
Journal of Army Medical University
基金
国家重点研发计划资助项目(2017YFC0110705)。
