文献类型：期刊文献

中文题名：机器人辅助全膝关节置换过程中创伤效应的利弊

英文题名：Advantages and disadvantages of trauma effects during robot-assisted total knee arthroplasty

作者：杨永泽[1];程晴灏[2];张安任[1];杨鑫[1];张壮壮[1];樊华[1];张福康[1];郭洪章[2]

第一作者：杨永泽

机构：[1]甘肃中医药大学第一临床医学院,甘肃省兰州市780000;[2]甘肃省人民医院骨科四病区,甘肃省兰州市780000

第一机构：甘肃中医药大学临床医学院

年份：2024

卷号：28

期号：21

起止页码：3413

中文期刊名：中国组织工程研究

外文期刊名：Chinese Journal of Tissue Engineering Research

收录：CSTPCD;;Scopus;北大核心:【北大核心2023】；

基金：甘肃省自然科学基金(20JR10RA358),项目负责人:郭洪章。

语种：中文

中文关键词：机器人辅助;全膝关节置换;传统术式;膝骨关节炎;创伤;利弊

外文关键词：robot assisted;total knee arthroplasty;traditional technique;knee osteoarthritis;trauma;advantages and disadvantages

摘要：背景:应用机器人辅助技术进行全膝关节置换是目前的研究热点之一。从20世纪80年代起,国外将机器人辅助技术引入全膝关节置换术中,以实现精准截骨和恢复良好的下肢力线。经过几十年的使用,机器人不断更新迭代性能更加优越,但因其增加围术期时间和手术创伤而受到批评。目的:总结现今骨科手术机器人在全膝关节置换过程中创伤方面的优缺点。方法:检索PubMed数据库和中国知网收录的有关分析手术机器人辅助全膝关节置换手术创伤优势及不足的文章,英文检索词为“arthroplasty,replacement,knee,knee replacement arthroplasty,procedure,robotic surgical,total knee arthroplasty,arthroplasty,replacement,knee,robotic-assisted”,中文检索词为“机器人辅助,机械臂,膝骨关节炎,关节炎”。根据纳入与排除标准对所有文章进行初筛后,保留质量和相关性较高的62篇文献进行综述。结果与结论:①手术机器人辅助全膝关节置换并未增加患者手术创伤程度,并且表现出比传统全膝关节置换更低的创伤效应;②手术机器人辅助全膝关节置换具有准确辅助截骨、个体化置入假体、更好地保护膝关节周围软组织、减少镇痛药物使用、降低术后炎症指标变化、缩短住院时间等降低创伤方面的优势,但也存在手术耗时延长、并发症增加、医疗成本提高等不足;③提示初步临床应用研究显示手术机器人辅助全膝关节置换可以降低手术创伤,但需要警惕潜在风险,同时与传统全膝关节置换相比其确切优势尚待大样本随机对照研究和长期随访来验证。
BACKGROUND:The application of robot-assisted technology for total knee arthroplasty is one of the current research hotspots.Since the 1980s,robot-assisted technology has been introduced into total knee arthroplasty outside China to achieve accurate osteotomy and good recovery of lower limb alignment.After decades of use,the robot has continuously improved its performance with new iterations,but has been criticized for increasing perioperative time and surgical trauma.OBJECTIVE:To summarize the advantages and disadvantages of current orthopedic surgical robots in total knee arthroplasty.METHODS:PubMed database and CNKI were searched to analyze the advantages and disadvantages of robot-assisted total knee arthroplasty in surgical trauma.English search terms were“arthroplasty,replacement,knee,knee replacement arthroplasty,procedure,robotic surgical,total knee arthroplasty,arthroplasty,replacement,knee,robotic-assisted”.The Chinese search terms were“robot-assisted,robotic arm,knee osteoarthritis,arthritis”.After the initial screening of all articles according to the inclusion and exclusion criteria,62 articles with high quality and relevance were reviewed.RESULTS AND CONCLUSION:(1)Robot-assisted total knee arthroplasty did not increase the degree of surgical trauma in patients,and showed a lower trauma effect than conventional manual total knee arthroplasty.(2)Robot-assisted total knee arthroplasty has the advantages of accurate auxiliary osteotomy,individualized prosthesis implantation,better protection of soft tissue around the knee joint,reduction of analgesic drug use,reduction of postoperative inflammatory index changes,and shortening of hospital stay.However,there are also shortcomings such as prolonged operation time,increased complications,and increased medical costs.(3)It is concluded that preliminary clinical application studies have shown that robot-assisted total knee arthroplasty can reduce surgical trauma,but it is necessary to be alert to potential risks.Simultaneously,its exact advantages compared with conventional manual total knee arthroplasty need to be verified by large-sample randomized controlled studies and long-term follow-up.