摘要
目的:探讨机器人辅助全膝关节置换术(RATKA)在治疗膝骨关节炎(KOA)中的应用价值,评估其临床疗效。方法:将2023年2月至2024年6月收治的72例膝骨关节炎患者按治疗方法分为两组(各36例),A组接受机器人辅助全膝关节置换术治疗,B组接受传统全膝关节置换术(TKA)治疗。比较两组患者手术时间、切口长度、术中出血量、引流量、血红蛋白差值等围术期指标,比较两组患者术前及术后髋-膝-踝角(HKA)偏移、股骨远端外侧角(LDFA)、胫骨近端内侧角(MPTA),比较两组患者术前及术后末次随访美国特种外科医院(HSS)评分、视觉模拟量表(VAS)评分及膝关节活动度(ROM)。结果:A组患者切口长度显著长于B组,差异有统计学意义(P<0.001),且血红蛋白差值更小,差异有统计学意义(P=0.005)。两组患者手术时长、术中出血量及引流量差异无统计学意义(P>0.05)。A组患者术后髋-膝-踝角偏移显著低于B组患者,差异有统计学意义(P=0.03),A组患者术后胫骨近端内侧角优于B组患者,且更接近90°,差异有统计学意义(P<0.05);两组患者术后髋-膝-踝角偏移、股骨远端外侧角和胫骨近端内侧角均较术前改善,差异有统计学意义(P<0.05);两组患者术后股骨远端外侧角比较差异无统计学意义(P>0.05)。两组患者术后HSS评分、VAS评分及膝关节活动度较术前均显著改善,差异有统计学意义(P<0.05),但组间差异无统计学意义(P>0.05)。结论:机器人辅助全膝关节置换术相较于传统全膝关节置换术,在提高手术精度、恢复下肢轴线方面具有优势,但在短期临床疗效上并未显示出显著差异。中药汤剂有助于促进术后康复,值得在临床中进一步探索其联合应用的潜力。
Objective:To explore the application value of robot-assisted total knee arthroplasty(RATKA)in the treatment of knee osteoarthritis(KOA)and evaluate its clinical efficacy.Methods:A total of 72 patients with KOA treated between February 2023 and June 2024 were divided into two groups based on the treatment method:group A(n=36)received RATKA,and group B(n=36)received traditional total knee arthroplasty(TKA).Intraoperative and perioperative indicators,including surgical time,incision length,intraoperative blood loss,drainage volume,and hemoglobin difference,were compared between the two groups.Pre-and postoperative hip-knee-ankle(HKA)alignment,lateral distal femur angle(LDFA),and medial proximal tibial angle(MPTA)were compared,as well as pre-and postoperative final follow-up Hospital for Special Surgery(HSS)scores,visual analogue scale(VAS)scores,and range of motion(ROM)of the knee.Results:The incision length in group A was significantly longer than that in group B(P<0.001),and the hemoglobin difference was smaller in group A,with a significant difference(P=0.005).No significant differences were observed between the groups in terms of surgical time,intraoperative blood loss,and drainage volume(P>0.05).Postoperatively,group A had a significantly lower HKA deviation than group B(P=0.03),and group A also showed better MPTA values,closer to 90°,with a significant difference(P<0.05).Both groups showed significant improvement in HKA deviation,LDFA,and MPTA postoperatively(P<0.05),but no significant difference was found in LDFA(P>0.05).Postoperative HSS scores,VAS scores,and ROM improved significantly in both groups(P<0.05),but no significant differences were found between the groups(P>0.05).Conclusion:RATKA has advantages over traditional TKA in improving surgical precision and restoring lower limb alignment,but no significant differences in short-term clinical outcomes were observed.Traditional Chinese medicine decoction may help promote postoperative recovery and warrants further exploration of its combined application in clinical practice.
作者
祁师亮
韩乐奇
杨开祥
王俊文
QI Shiliang;HAN Leqi;YANG Kaixiang;WANG Junwen(Wuhan Pu'ai Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430033,China;Department of Medicine,Jianghan University,Wuhan 430056,China)
出处
《中国中医骨伤科杂志》
2025年第6期75-80,共6页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
基金
武汉市医学科学研究健康发展项目面上项目(WX23A11)。
关键词
膝骨关节炎
关节置换
机器人手术
临床疗效
中药
knee osteoarthritis
arthroplasty
robotic surgery
clinical efficacy
traditional Chinese medicine
作者简介
通信作者:王俊文,E-mail:wjw0730@163.com。
