关节外科的未来——数字骨科技术在关节外科的应用

The future of joint surgery: the application of digital orthopaedic technology in joint surgery

数字骨科技术正在被越来越多地应用到关节外科临床实践中,包括人工智能技术、虚拟/增强/混合现实技术、3D打印技术、计算机导航、机器人辅助关节置换手术及其他数字骨科技术等。这些技术不断给关节外科医生赋能,使复杂的手术变得简单化,简单的手术实现精准化,精准的手术更加个体化,成为关节外科未来的重要发展方向。得益于计算机辅助设计和增材制造技术的进步,定制化的关节假体及骨组织修复材料为翻修术中复杂骨缺损的重建提供了极大的便利。各种类型的计算机辅助导航技术以及机器人辅助手术技术帮助医生显著提高了截骨和假体植入的精准性。然而,要从根本上提高患者髋、膝关节置换术后的满意度,还需要借助数字骨科技术深入探索髋、膝关节置换的理想目标值,进而借助个性化的术前计划、更加客观精准的软组织平衡评估技术并结合精准的术中操作,甚至结合使用定制化假体,来实现个体化的精准关节置换。现有的各种数字骨科技术都有其各自的优势与不足,关节外科医生应当对这些技术有深入的了解,充分合理地应用这些技术造福于广大患者。

Digital orthopedic technologies are increasingly being applied to the clinical practice of joint surgery.These technologies include artificial intelligence,virtual/augmented/mixed reality,3D printing,computer navigation,robotic-assisted joint replacement surgery,and other digital orthopedic technologies.Digital orthopedic technologies continue to empower joint surgeons,simplify complex operations,achieve precision in simple operations,and to make precise operations more individualized.Thus,they are becoming important development directions for joint surgery in the future.With the help of advances in computer-aided design and additive manufacturing technology,customized joint prostheses and bone tissue repair materials provide great convenience for reconstruction of complex bone defects during revision surgery.Various types of computer-assisted navigation technologies and robot-assisted surgery technologies can help doctors improve the accuracy of osteotomy and prosthesis implantation significantly.However,to fundamentally improve patients'satisfaction after joint replacements,we need to use digital orthopedics technologies to explore the ideal target value of arthroplasty.Further,we use personalized preoperative planning with objective and accurate assessment technology of soft tissue balance,precise intraoperative operations,and the use of customized prostheses to achieve individualized and precise joint arthroplasty.Various digital orthopedic technologies have their own advantages and disadvantages.Joint surgeons should have an in-depth understanding of these technologies and make full and reasonable use of these technologies to benefit the majority of patients.