主动机器人系统在人工全髋关节置换术中的应用

Application of active-robotic system in total hip joint replacement

目的探讨主动式机器人系统在全髋关节置换术中的应用价值及技术要点。方法以2017年8月河南省人民医院骨科收治的5名(纳入标准为:股骨头坏死骨循环研究协会分期(ARCO)ⅡC-Ⅳ期;排除标准:重度骨质疏松症、脑卒中后遗症、关节骨性强直等)拟接受单侧全髋关节初次置换的股骨头坏死患者为研究对象进行前瞻性研究,将CT扫描数据录入术前规划系统(TPLAN)后进行术前规划。切后外侧入路进行显露,使用术中动力系统(TCAT)依次进行股骨侧注册、股骨侧切骨、髋臼侧注册、髋臼侧磨挫,完成操作后安装假体。结果所有5名患者手术过程顺利,术后复查片假体位置良好,双下肢等长,术后2 d拄拐下床活动,随访期间无并发症。结论主动式全髋关节机器人系统可以提高髋关节置换手术的精准度,获得更优的髋关节重建结果,初步体会在初次全髋关节置换手术中具有良好应用前景。

Objective To investigate the application of active robot assisted total hip joint replacement （ THR ） ,as well as the critical techniques .Methods Five patients addmited in Henan People＇ s Provincial Hospital since August ,2017 were included in the study .Inclusion criteria was necrosis of femoral head staged from ⅡC to Ⅳ the Association Research of Circulation Osseous （ ARCO ） classification.Exclusion criteria was severe osteoporosis ,cerebral apoplexy ,and bony ankylosis .All the five patients underwent THA with posterior-lateral approach .The operation using active robotic system included the registration of femur ,osteotomy and reaming of femur ,registration of actabullum ,bone preparation of femur ,and implantation of prosthesis .Results All the five patients got well rehabilitation following the operation .X-ray showed satisfactory outcome of implants position and limb discrepancy .No complication was found during the follow-up.Conclusion The active robotic system is conducive to the precise bone-cutting and implantation ,and consequently may increase the efficacy of THR .