| 摘要: |
| ［摘要］ 目的 比较MAKO机器人与传统器械辅助全膝关节置换术（TKA）对关节线高度的影响。方法 回顾性纳入2021年1月至2023年12月在北京大学第三医院接受Stryker假体植入行TKA的患者691例，其中接受MAKO机器人辅助手术611例（机器人组），接受传统器械辅助手术80例（传统组），并采用1∶1倾向评分匹配以平衡潜在偏倚。在倾向评分匹配后，共纳入了160例患者进行统计分析，其中机器人组80例，传统组80例。主要结局指标为术后关节线高度的变化；次要结局指标包括手术时间、麻醉时间、髌骨位置、下肢力线等。结果 机器人组手术时间、麻醉时间长于传统组，但两组比较差异无统计学意义（P>0.05）。机器人组术后关节线高度变化、过度上移率显著低于传统组（P<0.05）。传统组术后关节线高度变化绝对值、高度异常率高于机器人组，但差异无统计学意义（P>0.05）。两组术后髌骨位置异常发生率比较差异无统计学意义（P>0.05）。两组术后髋-膝-踝角、股骨远端外侧角、胫骨近端内侧角的偏离值和异常率比较差异均无统计学意义（P>0.05）。结论 MAKO膝关节系统在TKA中可更好恢复关节线高度。 |
| 关键词: 全膝关节置换 机器人手术 关节线高度 髌骨高度 下肢力线 |
| DOI：10.3969/j.issn.1674-3806.2026.05.05 |
| 分类号:R 684 |
| 基金项目:北京市自然科学基金-昌平创新联合基金项目（编号：L234012，L254010）；北京大学第三医院临床队列建设项目（编号：BYSYDL2023007） |
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| Effects of MAKO robotic-assisted and conventional device-assisted total knee arthroplasty on joint line height: a propensity score-matched study at 1∶1 |
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ZHENG Yuhang1,2, DONG Ziyang1,2, WANG Xinguang1,2, LI Yang1,2, TIAN Hua1,2
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1.Department of Orthopedics, Peking University Third Hospital, Beijing 100191, China; 2.Ministry of Education Engineering Research Center for Precision Medicine of Bones and Joints, Beijing 100191, China
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| Abstract: |
| ［Abstract］ Objective To compare the effects of MAKO robotic-assisted and conventional device-assisted total knee arthroplasty(TKA) on joint line(JL) height. Methods A total of 691 patients who underwent TKA with Stryker prosthesis implantation in Peking University Third Hospital from January 2021 to December 2023 were retrospectively included in this study. The patients who received MAKO robotic-assisted TKA(611 cases) were assigned to the robotic group, and those who received conventional device-assisted TKA(80 cases) were assigned to the conventional group. The propensity score matching at a 1∶1 ratio was used to balance potential biases. After the propensity score matching, a total of 160 patients were included for statistical analysis, including 80 patients in the robotic group and 80 patients in the conventional group. The primary outcome measure was the change of postoperative JL height. The secondary outcome measures included operative duration, anesthesia duration, patellar position and lower limb alignment. Results The operative duration and the anesthesia duration of the robotic group were longer than those of the conventional group, but there were no statistically significant differences between the two groups(P>0.05). The changes of postoperative JL height and the rate of excessive upward shifts of the postoperative JL in the robotic group were significantly lower than those in the conventional group(P<0.05). The absolute value of the postoperative JL height changes and the rate of abnormal heights in the conventional group were higher than those in the robotic group, but the differences were not statistically significant(P>0.05). There was no statistically significant difference in the incidence of abnormal patellar position between the two groups after the operation(P>0.05). There were no statistically significant differences in the deviation values and abnormal rates of the hip-knee-ankle angle, the lateral distal femoral angle and the medial proximal tibial angle between the two groups after the operation(P>0.05). Conclusion The MAKO knee system can better restore JL height in TKA. |
| Key words: Total knee arthroplasty(TKA) Robotic-assisted surgery Joint line(JL) height Patella height Lower limb alignment |
