摘要
[目的]比较导航辅助与传统技术全膝置换(total knee arthroplasty,TKA)治疗膝骨关节炎内翻畸形的临床疗效。[方法]回顾性分析2021年1月—2023年10月在本院采用TKA术治疗的膝骨关节炎内翻畸形92例患者的临床资料。依据术前医患沟通结果,46例采用导航辅助TKA术(导航组),46例采用传统TKA术(传统组)。比较两组围术期、随访以及影像资料。[结果]导航组的手术时间显著长于传统组[(97.2±7.8)min vs(86.7±6.5)min,P<0.001],但前者的出血量显著少于后者[(224.1±21.8)mL vs(240.2±23.6)mL,P<0.001],两组切口长度、首次下床时间、住院时间、切口愈合时间、并发症发生率差异无统计学意义(P>0.05)。随着时间推移,两组患者WOMAC评分、VAS评分均逐渐降低,HSS评分、伸-屈ROM均逐渐升高(P<0.05),相应时间点两组间上述指标的差异均无统计学意义(P>0.05)。影像方面,与术前相比,末次随访时两组的FTA角显著降低,而MPTA角和PTS角均增加(P<0.05)。末次随访时,导航组的FTA角显著小于传统组[(172.7±10.5)°vs(178.4±12.6)°,P<0.05],而前者的MPTA角显著大于后者[(87.7±7.4)°vs(78.8±6.5)°,P<0.001]。[结论]导航辅助TKA术治疗膝骨关节炎内翻畸形能获得与传统TKA手术治疗一致的临床疗效,导航辅助手术时间长,但出血量更少,下肢力线矫正效果更佳。
[Objective] To compare the clinical efficacy of robot-assisted total knee arthroplasty (TKA) versus traditional technique TKA for knee osteoarthritis complicated with varus deformity. [Methods] A retrospective study was conducted on 92 patients who received TKA for knee osteoarthritis complicated with varus deformity in our hospital from January 2021 to October 2023. According to preoperative doctor-patient communication, 46 patients received robot-assisted TKA (robot group), while other 46 patients received traditional TKA (traditional group). The perioperative, follow-up and imaging data were compared between the two groups. [Results] Although the robot group consumed significantly longer operative time than the traditional group [(97.2±7.8) min vs (86.7±6.5) min, P<0.001], the former had significantly less blood loss than the latter group [(224.1±21.8) mL vs [240.2±23.6] mL, P<0.001]. However, there was no significant difference in incision length, bed rest time, hospital stay, incision healing time and complication rate between the two groups (P>0.05). The WOMAC score and VAS score were significantly decreased, while HSS score and extension-flexion ROM were significantly increased in both groups over time (P<0.05), which were not statistically significant between the two groups at any time points accordingly (P>0.05). Regarding to imaging, the FTA was significantly decreased, while the MPTA and PTS were increased in both groups postoperatively compared with those preoperatively (P<0.05). At the latest follow-up, the robot group had significantly lesser FTA [(172.7±10.5)° vs (178.4±12.6)°, P<0.05], while significantly greater MPTA than the traditional group [(87.7±7.4)° vs (78.8±6.5)°, P<0.001]. [Conclusion] Robot-assisted TKA for knee osteoarthritis complicated with varus deformity achieves the same clinical efficacy as traditional TKA surgery. However, the robot-assisted surgery has longer operation time, less blood loss, and better lower limb alignment correction.
作者
汪俊红
柳海平
赵宁
马继海
李兴国
WANG Jun-hong;LIU Hai-ping;ZHAO Ning;MA Ji-hai;LI Xing-guo(Department of Bone and Joint Surgery,Gansu Provincial Hospital of Traditional Chinese Medi-cine,Lanzhou 730050,Gansu,China)
出处
《中国矫形外科杂志》
北大核心
2025年第11期981-986,共6页
Orthopedic Journal of China
关键词
导航
全膝关节置换术
膝骨关节炎
膝关节内翻畸形
下肢力线
robot
total knee arthroplasty
knee osteoarthritis
knee varus deformity
lower limb alignment
