机器人系统辅助的膝关节单髁置换术治疗老年膝关节骨关节炎的临床效果

目的 探讨机器人手术系统辅助下膝关节单髁置换术(UKA)和传统膝关节单髁置换术治疗老年患者膝关节骨关节炎的疗效。方法 选择2018年1月至2020年6月就诊于解放军总医院第一医学中心78例老年膝关节骨关节炎患者为研究对象,按照随机数表法随机分为2组,每组39例。观察组实施MAKO RIO机器人手术系统辅助下UKA,对照组实施常规膝关节单髁置换术。对比2组患者围术期情况,术后8、16、24h 2组患者视觉模拟评分法(VAS)及术后6个月美国膝关节协会评分(KSS)。结果 观察组单侧 UKA手术时间(155±22) min、术中止血带使用时间 (27±10) min、术后第2天总失血量 (476±290) ml；对照组分别为 (135±21) min、(40±9) min、(536±215) ml,差异均有统计学意义(均P<0.05)。观察组术后8、16h VAS评分分别为(3.2±1.2)、(1.8±0.8) 分,对照组分别为(4.6±1.4)、(2.3±1.1)分,差异均有统计学意义(均P<0.05)。观察组和对照组术后24h VAS评分分别为(1.1±0.3)、(1.2±0.5)分,差异无统计学意义(P>0.05)。对照组术后6个月随访患侧膝关节KSS临床评分和功能评分分别为(78±11)、(70±16)分,观察组分别为(90±6)、(79±12)分,差异均有统计学意义(均P<0.05)。结论 机器人手术系统辅助UKA能够实现微创条件下精准手术,具有良好的安全性,促进了手术患者膝关节功能改善。

Clinical efficiency of robot system assisted unicompartmental knee arthroplasty for treatment of knee osteoarthritis in elderly patients

Objective To compare the clinical effectiveness of robot system assisted unicompartmental knee arthroplasty and traditional surgery in the treatment of knee osteoarthritis in the elderly patients. Methods A total of 78 elderly patients with knee osteoarthritis admitted to Chinese PLA General Hospital from January 2018 to June 2020 were prospectively recruited in this study. They were randomly divided into observation group (n=39) and the control group (n=39), with the former group undergoing robot system-assisted UKA and the latter traditional surgery. Their perioperative data, visual analogue scale (VAS) scores at 8,16, 24 h after surgery, and knee society score (KSS) at 6 months postoperatively were collected and compared between the 2 groups. Results The observation group had significantly longer operation time (155±22) vs (135±22) min] and shorter use time of intraoperative tourniquet (27±10) vs (40±9) min], and obviously less total blood loss on the second day after operation (476±290) vs (536±215) ml] when compared with the control group (all P<0.05). The VAS scores at 8 and 16 h after surgery were (3.2±1.2) and (1.8±0.8) points in the observation group and (4.6±1.4) and (2.3±1.1) points in the control group, and significant differences were seen between the 2 groups (all P<0.05). But no such difference was observed in the score at 24 h (1.1±0.3) vs (1.2±0.5) points, P>0.05]. At 6 months postoperatively, statistical differences were seen in the KSS score (78±11) vs (90±6)points] and functional score (70±16) vs (79±12)points] between 2 groups (both P<0.05). Conclusion Robot system-assisted UKA can provide excellent precision and safety through a minimally invasive approach, and promote postoperative knee function recovery in patients.