机器人辅助髓芯减压术和传统髓芯减压术治疗早期股骨头坏死的病例对照研究

Case-control study on robot-assisted core decompression and conventional core decompression for early necrosis of femoral head

目的:比较机器人辅助髓芯减压术和传统髓芯减压术治疗ARCOⅠ期股骨头坏死的临床疗效。方法:回顾性分析2018年2月至2020年2月行髓芯减压术的ARCOⅠ期股骨头坏死患者60例(均为单侧手术),其中行骨科机器人辅助导航下髓芯减压术患者30例(RCD组),男19例,女11例;年龄17~58(38.50±10.61)岁。行常规髓芯减压术患者30例(CCD组),男20例,女10例;年龄20~55(40.63±10.63)岁。记录并比较两组患者术中X线透视次数、术中出血量和手术时间,并比较术前、术后24个月Harris评分、视觉模拟评分(visual analogue scale,VAS)。结果:所有患者获得随访,RCD组随访时间21~26(23.40±1.65)个月,CCD组21~26(23.30±1.66)个月,两组比较差异无统计学意义(P>0.05)。RCD组术中X线透视次数、术中出血量、手术时间分别为(9.43±1.14)次、(153.80±22.04)ml、(33.40±1.87)min,CCD组分别为(19.67±1.32)次、(165.04±20.41)ml、(54.75±3.46)min,两组比较差异有统计学意义(P<0.05)。两组术后24个月Harris评分、VAS比较差异无统计学意义(P>0.05)。结论:相比传统髓芯减压术,骨科机器人导航辅助下进行髓芯减压治疗ARCOⅠ期股骨头坏死可减少术中X线透视次数,缩短手术时间,降低手术风险。

Objective:To compare clinical effect of robot-assisted core decompression and conventional core decompression in treating ARCOⅠstage necrosis of femoral head.Methods:A retrospective analysis was performed on 60(unilateral operation)patients who underwent core decompression for femoral head necrosis from February 2018 to February 2020.Among them,30 patients(30 hips)were underwent robot-assisted core decompression(RCD group),including 19 males and 11 females,aged from 17 to 58 years old with an average of(38.50±10.61)years old;30 patients(30 hips)were underwent traditional core decompression surgery(CCD group),including 20 males and 10 females,aged from 20 to 55 years old with an average of(40.63±10.63)years old.Intraoperative fluoroscopy times,intraoperative blood loss and operation time between two groups,and Harris score,visual analogue scale(VAS)before opertaion and 24 months after operation were compared.Results:All patients were followed up,RCD group followed up from 21 to 26 months with an average of(23.40±1.65)months,CCD group followed up from 21 to 26 months with an average of(23.30±1.66)months,and had no difference between two groups(P>0.05).The number of intraoperative X-ray fluoroscopy,intraoperative blood loss and operative time in RCD group were(9.43±1.14)times,(153.80±22.04)ml,(33.40±1.87)min,respectively;while(19.67±1.32)times,(165.04±20.41)ml and(54.75±3.46)min in CCD group respectively;and there were statistical difference between two groups(P<0.05).In addition,there were no statistical difference between two groups in Harris score and VAS at 24 months after operation(P>0.05).Conclusion:Compared with conventional core decompression,robot-assisted core decompression could reduce the number of intraoperative fluoroscopy,shorten operation time,and reduce risk of surgery.