机器人辅助膝关节单髁置换术的研究进展

doi:10.3877/cma.j.issn.1674-134X.2023.05.018

近年来，膝关节单髁置换术(UKA)在治疗单间室膝关节骨关节炎(KOA)方面取得了令人满意的效果，随着机器人辅助技术的飞速发展并逐渐与临床相结合，机器人辅助UKA(rUKA)因提高了截骨、假体植入位置的精度、减少了恢复术后下肢力线的误差，得到了临床医生的广泛关注。但rUKA同样有其局限性，比如较高的成本、早期较长的手术时间以及一些相关的并发症。同时，早期的临床疗效很好，但中期随访显示rUKA在假体生存率方面并没有优势。由于缺乏长期随访的结果，目前尚不清楚提高假体植入的精度能否改善临床预后、提高假体生存率。然而，提高假体植入的精度对患者可能是有益的，因此机器人辅助技术值得被用于UKA中。本文通过简要介绍rUKA的历史、组成及分类、手术操作系统的分类、现状疗效以及预后、优缺点，就目前rUKA在临床上的应用作一综述。

关键词: 机器人手术, 关节成形术，置换，膝, 骨关节炎，膝

In recent years, unicompartmental knee arthroplasty (UKA) has achieved satisfactory results in the treatment of single-compartment knee osteoarthritis (KOA), with the rapid development of robot-assisted technology and gradually combined with clinical practice, robotic-assisted UKA (rUKA) has received extensive attention from clinicians because it improves the accuracy of osteotomy, prosthesis placement position, and reduces the error of lower limb force line after recovery. But rUKA also has its limitations, such as higher cost, longer surgery time and associated complications. At the same time, the early clinical effect is good, but the interim follow-up showed that rUKA did not have an advantage in prosthesis survival. Due to the lack of long-term follow-up results, it is unclear whether improving the precision of prosthesis implantation improves clinical outcomes and improves prosthesis survival. However, improving the precision of prosthetic implantation could be beneficial for patients, so robotic-assisted technology is worth using in the UKA. This article briefly introduced the history, composition and classification of rUKA, classification of surgical operating systems, current efficacy, prognosis, advantages and disadvantages, and reviewed the current clinical application of rUKA.

Key words: Robotic surgical procedures, Arthroplasty, replacement, knee, Osteoarthritis, knee

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