机器人辅助下膝内侧单髁置换术后假体位置分析和早期临床疗效

Analysis of Postoperative Component Positioning and Early Clinical Outcome after Robot-assisted Unicompartmental Knee Arthroplasty

目的比较机器人辅助下膝关节单髁置换术(robotic-assisted unicompartmental knee arthroplasty,RAUKA)与传统膝单髁置换术(UKA)治疗膝内侧间室骨关节炎(OA)的术后早期临床疗效和假体位置。方法对2022年6月至2022年10月在我院行UKA治疗的病人的临床资料进行回顾性分析。其中,RAUKA组32例(32膝),按照年龄、性别及术肢侧别等进行1∶1配对,选择同期行传统UKA术的32例病人(32膝)纳入传统UKA组。RAUKA组男7例,女25例,年龄为(69.2±6.1)岁。传统UKA组男6例,女26例,年龄为(68.9±5.8)岁。记录并比较两组病人手术时间及美国膝关节协会评分(KSS)、疼痛视觉模拟量表(VAS)、膝关节遗忘(FJS)评分等,测量并比较两组术后的股骨假体内外翻角(A角)、股骨假体屈伸角(B角)、胫骨假体内外翻角(E角)、胫骨假体后倾角(F角)、假体偏离总体评分及胫股角(FTA)、髋膝踝角(HKA)及下肢机械轴Kennedy区分布等。结果两组病人手术均顺利完成并获得随访,术后随访(13.8±1.3)个月,RAUKA组的手术时间与术中截骨时间长于传统UKA组。两组术后的A角及B角比较,差异有统计学意义(P<0.05),RAUKA组的假体总偏离评分显著优于传统UKA组,差异有统计学意义(P<0.05)。两组的E角、F角、FTA、HKA、下肢机械轴Kennedy区分布及KSS、VAS、FJS评分等比较,差异无统计学意义(P>0.05)。两组随访期间均无感染、假体松动等并发症发生。结论RAUKA相较传统UKA具有术后假体位置更精准、术后下肢力线矫正优良率更高的优势,传统UKA在手术时间方面优于RAUKA。RAUKA早期临床疗效满意,远期疗效如何有待进一步随访。

Objective To compare the early clinical outcomes and postoperative component positioning of robot-assisted unicompartmental knee arthroplasty(RAUKA)with conventional manual unicompartmental knee arthroplasty(UKA)in the treatment of medial knee osteoarthritis.Methods Patients who underwent UKA in our hospital from June 2022 to October 2022 were selected and their clinical data were analyzed retrospectively.In all these patients,32 patients(32 knees)who underwent UKA assisted by robot served as the RAUKA group,and 32 patients(32 knees)with conventional manual UKA performed during the same period by a 1∶1 matching according to age,sex,and side of the operated limb were included in the traditional UKA group.There were 7 males and 25 females in the RAUKA group,with an age of(69.2±6.1)years.There were 6 males and 26 females in the traditional UKA group,with an age of(68.9±5.8)years.The operation time and the knee society score(KSS),the visual analogue scale(VAS),the forgotten joint score(FJS)were recorded and compared between the two groups.The femoral component internal and external rotation angle(angle A),femoral component flexion and extension angle(angle B),tibial component internal and external rotation angle(angle E),tibial component posterior inclination angle(angle F),the overall score of component deviation and tibiofemoral angle(FTA),hip-knee-ankle angle(HKA),the distribution of the Kennedy zone of the lower limbs postoperatively were measured and compared between the two groups.Results All patients in the two groups were successfully given the surgery with a mean postoperative follow-up of(13.8±1.3)months.The operative time and intraoperative osteotomy time in the RAUKA group were significantly longer than those in the conventional UKA group(P<0.05).There were statistically significant difference in angle A and angle B between the two groups(P<0.05).The total component deviation score in the RAUKA group was significantly better than that in the conventional UKA group(P<0.05).Comparison of the angle E,angle F,FTA,HKA,distribution of the Kennedy zone of the mechanical axis of the lower limb,the KSS,VAS,FJS between the two groups showed no statistically significant difference(P>0.05).There were no complications such as infection or component loosening during the follow-up period in both groups.Conclusion RAUKA offers advantages over conventional UKA in terms of more precise postoperative component positioning and superior postoperative lower limb alignment.Conventional UKA is superior to RAUKA in terms of operating time.The short-term efficacy of RAUKA is excellent,but the long-term outcomes need to be further investigated.