机器人辅助全膝关节置换术治疗膝骨关节炎临床效果研究

Clinical effect of robot-assisted total knee arthroplasty in the treatment of knee osteoarthritis

目的:探究机器人辅助全膝关节置换术在膝骨关节炎患者中的临床应用效果。方法:选取2020年6月—2023年6月西安市4家医院收治的92例膝骨关节炎患者实施前瞻性研究,按照随机数字表法分为研究组和对照组,每组46例。对照组实施传统全膝关节置换术,研究组实施机器人辅助全膝关节置换术,比较两组患者手术指标、Hb、Hct、疼痛程度、影像学评价指标、膝关节功能、并发症情况。结果:与对照组相比,研究组手术时间更长。与术前相比,术后两组Hb、Hct均降低,但两组间比较差异无统计学意义。与术后8 h相比,术后16 h、24 h两组疼痛视觉模拟评分法(VAS)评分均降低,且术后24 h VAS评分更低,术后8 h、16 h研究组VAS评分低于对照组。与术前相比,术后6个月两组胫骨近端内侧角(MPTA)、股骨远端外侧角(LDFA)均升高,髋-膝-踝角(HKA)偏移、关节线收敛角(JLCA)均降低,且研究组HKA偏移、JLCA更低。与术前相比,术后6个月两组西安大略和麦克马斯特大学骨关节炎指数(WOMAC)各项评分均降低,美国膝关节协会评分(KSS)各项评分及膝关节活动度(ROM)均升高,且研究组术后6个月ROM高于对照组,但两组间WOMAC评分、KSS评分比较,差异无统计学意义。两组患者术后随访6个月,均未发生手术相关并发症。结论:机器人辅助全膝关节置换术治疗膝骨关节炎具有较好效果,可有效缓解术后疼痛,提高治疗效果,安全性较好。

Objective:To investigate the clinical effect of robot-assisted total knee arthroplasty(TKA)in the treatment of patients with knee osteoarthritis.Methods:92 patients with knee osteoarthritis admitted to the four hospitals in Xi’an from June 2020 to June 2023 were selected for prospective study.They were divided into the study group and the control group using a random number table method,with 46 cases in each group.Conventional TKA was performed in the control group,and robot-assisted TKA was performed in the study group.The surgical indexes,Hb,Hct,pain level,imaging evaluation indexes,knee joint function,and complications between the two groups were compared.Results:Compared with the control group,the study group had a longer operative time.Compared with that before surgery,Hb and Hct levels were both decreased in the two groups after surgery,but the difference between the two groups was not statistically significant.Compared with that 8 h after surgery,visual analogue scales(VAS)scores of the two groups were both decreased at 16 h and 24 h after surgery,and more lower at 24 h after surgery,and they were lower in the study group than those in the control group at 8 h and 16 h after surgery.Compared with that before surgery,the medial proximal tibial angle(MPTA)and lateral distal femoral angle(LDFA)were raised,and the hip-knee-ankle angle(HKA)excursion and the joint-line convergence angle(JLCA)were reduced in the two groups at 6 months after surgery,and the HKA excursion and JLCA were lower in the study group than those in the control group.The Western Ontario and McMaster Universities Osteoarthritis index(WOMAC)scores were lower in the two groups at 6 months after surgery,while the knee society score(KSS)scores and range of motion(ROM)were higher,and ROM was higher in the study group than that in the control group at 6 months after surgery,but the differences in WOMAC and KSS scores were not statistically significant between the two groups.There were no surgical-related complications in both groups during the 6-month follow-up.Conclusion:Robot-assisted TKA has good effect in treating knee osteoarthritis,which can effectively alleviate postoperative pain,improve the therapeutic effect with better safety.