摘要
目的:旨在评估国产机器人辅助下经直接前路入路(DAA)行全髋关节置换术(THA)的安全性、精准性及临床疗效。方法:回顾性分析2024年1月~2024年8月采用国产“键嘉”机器人辅助DAA入路行THA的48例患者(48髋)。记录手术时间、切口长度、出血量、住院天数及并发症;术后通过CT测量髋臼杯外展角、前倾角、联合偏心距差及下肢长度差,并与术前规划对比。采用Pearson相关性分析评估精准性。结果:①手术指标:手术时间(95.62±16.35)min,切口长度(8.54±1.81)cm,术中出血量(400.58±150.71)mL,住院时间(9.15±2.47)d。②假体定位精准性:髋臼杯外展角偏差(3.12±2.45)°,前倾角偏差(2.13±1.56)°;联合偏心距差异(2.01±1.87)mm,下肢长度差异(2.32±2.05)mm;97.92%(47/48)外展角、89.58%(43/48)前倾角位于Lewinnek安全区;83.33%(40/48)偏心距差异≤5mm,97.92%(47/48)下肢长度差异≤10mm;术后测量值与术前规划高度相关(前倾角r=0.795,P<0.001)。③功能恢复:Harris髋关节功能评分从术前(32.50±3.10)分提升至术后6个月(89.20±6.50)分,优良率达95.83%。④并发症:1例股外侧皮神经麻痹(3个月后缓解);1例下肢长度差异>10mm(未诉不适);无脱位、感染或假体松动病例。结论:国产机器人辅助DAA-THA能精准实现术前规划,显著提升假体定位准确性,加速术后功能恢复,降低并发症风险,是安全有效的术式。
Objective:This study aimed to evaluate the safety,accuracy,and clinical efficacy of total hip arthroplasty(THA)performed via the direct anterior approach(DAA)using a domestically produced robotic system.Methods:A retrospective analysis was conducted on 48 patients(48 hips)who underwent robotassisted DAA-THA using the domestic“Jianjia”robotic system from January 2024 to August 2024.Operative time,incision length,blood loss,hospital stay,and complications were recorded.Postoperative CT measurements assessed acetabular cup abduction angle,anteversion angle,combined offset discrepancy,and limb length discrepancy(LLD),which were compared with preoperative plans.Pearson correlation analysis evaluated accuracy.Results:①Surgical metrics:Operative time(95.62±16.35)min,incision length(8.54±1.81)cm,intraoperative blood loss(400.58±150.71)mL,hospital stay(9.15±2.47)days.②Implant positioning accuracy:Acetabular cup abduction angle deviation(3.12±2.45)°,anteversion angle deviation(2.1±1.5)°,combined offset discrepancy(2.01±1.87)mm,LLD(2.32±2.05)mm.Safety zone achievement:97.92%(47/48)of abduction angles and 89.58%(43/48)of anteversion angles were within the Lewinnek safe zone;83.33%(40/48)had offset discrepancy≤5mm,and 97.92%(47/48)had LLD≤10mm.Correlation:Postoperative measurements strongly correlated with preoperative plans(anteversion angle:r=0.795,P<0.001).③Functional recovery:Harris Hip Score improved from preoperative(32.50±3.10)points to(89.20±6.50)points at 6 months postoperatively,with an excellent/good rate of 95.83%.④Complications:1 case of lateral femoral cutaneous nerve palsy(resolved after 3 months);1 case of LLD>10mm(no discomfort reported);No dislocations,infections,or prosthetic loosening.Conclusion:THA performed via the DAA approach assisted by the domestic robotic system accurately executed preoperative plans,significantly improved prosthesis positioning accuracy,accelerated functional recovery,and reduced complication risks,demonstrating it to be a safe and effective procedure.
作者
蔡敏
孙可
石泽锋
金先跃
肖仕辉
王贤
CAI Min;SUN Ke;SHI Ze-feng;JIN Xian-yue;XIAO Shi-hui;WANG Xian(Department of Joint and Sports Medicine Surgery,Guangxi Zhuang Autonomous Region People’s Hospital,Guangxi Nanning 530021)
出处
《中国医疗器械信息》
2025年第15期103-105,158,共4页
China Medical Device Information
