机器人辅助与传统技术在髋臼骨折后全髋关节置换术中的中期疗效比较

doi:10.6040/j.issn.1671-7554.0.2026.0145

摘要/Abstract

摘要： 目的探讨机器人辅助技术在髋臼骨折后全髋关节置换术(total hip arthroplasty, THA)中的应用价值和中期疗效。方法回顾性分析2019年6月至2023年8月首都医科大学附属北京积水潭医院收治的髋臼骨折后接受THA患者49例,经核对原始资料后,最终纳入完整统计分析患者40例,其中机器人辅助组20例,传统技术组20例。比较两组基线资料、围手术期指标、临床结局及影像学结果。结果两组基线资料和围手术期一般情况差异均无统计学意义(P>0.05)。末次随访,两组间Harris髋关节评分均较术前明显提高(P<0.001),两组间末次随访Harris髋关节评分和FJS评分差异均无统计学意义(P>0.05)。机器人辅助组髋臼假体外展角、前倾角及位于Lewinnek安全区和Callanan安全区的比例均高于传统技术组,差异有统计学意义(P<0.05)。机器人辅助组V-COR差值和术后下肢长度差均小于传统技术组,差异有统计学意义(P<0.05),而两组H-COR差值、V-COR差值>10 mm和H-COR差值>10 mm患者比较差异均无统计学意义(P>0.05)。结论对于髋臼骨折后THA,机器人辅助技术与传统技术均可获得良好的中期临床疗效;与传统技术相比,机器人辅助技术可提高髋臼假体植入准确性,并更有利于术后下肢长度恢复。

关键词: 机器人辅助技术, 髋臼骨折, 全髋关节置换术, 中期疗效, 假体植入准确性

Abstract: Objective To investigate the application value and mid-term outcomes of robot-assisted technology in total hip arthroplasty(THA)following acetabular fractures. Methods A retrospective analysis was conducted on 49 patients who underwent THA after acetabular fractures at Beijing Jishuitan Hospital between June 2019 and August 2023. After verification of the original data, 40 patients with complete clinical and radiographic data were finally included in the statistical analysis, including 20 patients in the robot-assisted group and 20 patients in the conventional technique group. Baseline characteristics, perioperative parameters, clinical outcomes, and radiographic results were compared between the two groups. Results There were no significant differences in baseline characteristics or perioperative general conditions between the two groups(P>0.05). At the final follow-up, Harris hip scores in both groups were significantly improved compared with preoperative values(P<0.001), while no significant differences were observed between the two groups in terms of final Harris hip scores or Forgotten Joint Score(FJS)(P>0.05). The robot-assisted group demonstrated significantly higher accuracy in acetabular cup abduction angle, anteversion angle, and proportions within the Lewinnek safe zone and Callanan safe zone compared with the conventional technique group(P<0.05). In addition, the robot-assisted group showed significantly smaller vertical center of rotation(V-COR)deviation and postoperative leg length discrepancy than the conventional technique group(P<0.05). However, there were no significant differences between the two groups in horizontal center of rotation(H-COR)deviation, the proportion of patients with V-COR deviation >10 mm, or the proportion with H-COR deviation >10 mm(P>0.05). Conclusion Both robot-assisted and conventional techniques can achieve satisfactory mid-term clinical outcomes in THA following acetabular fractures. Compared with the conventional technique, robot-assisted technology improves the accuracy of acetabular component implantation and is more favorable for postoperative restoration of leg length.

Key words: Robot-assisted technology, Acetabular fracture, Total hip arthroplasty, Mid-term outcomes, Accuracy of prosthesis implantation

中图分类号:

R687.3

张纪,韩铁龙,王兴山,蒋毅. 机器人辅助与传统技术在髋臼骨折后全髋关节置换术中的中期疗效比较[J]. 山东大学学报 (医学版), 2026, 64(8): 71-78.

ZHANG Ji, HAN Tielong, WANG Xingshan, JIANG Yi. Mid-term outcomes of robot-assisted versus conventional total hip arthroplasty after acetabular fracture[J]. Journal of Shandong University (Health Sciences), 2026, 64(8): 71-78.

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