目的：探究机器人辅助全膝关节置换术在膝骨关节炎患者中的临床应用效果。方法：选取2020年6月— 2023 年 6 月西安市 4 家医院收治的 92 例膝骨关节炎患者实施前瞻性研究，按照随机数字表法分为研究组和对照组， 每组 46 例。对照组实施传统全膝关节置换术，研究组实施机器人辅助全膝关节置换术，比较两组患者手术指标、 Hb、Hct、疼痛程度、影像学评价指标、膝关节功能、并发症情况。结果：与对照组相比，研究组手术时间更长。 与术前相比，术后两组 Hb、Hct 均降低，但两组间比较差异无统计学意义。与术后 8 h 相比，术后 16 h、24 h 两组 疼痛视觉模拟评分法（VAS）评分均降低，且术后 24 h VAS 评分更低，术后 8 h、16 h 研究组 VAS 评分低于对照组。 与术前相比，术后 6 个月两组胫骨近端内侧角（MPTA）、股骨远端外侧角（LDFA）均升高，髋 - 膝 - 踝角（HKA） 偏移、关节线收敛角（JLCA）均降低，且研究组 HKA 偏移、JLCA 更低。与术前相比，术后 6 个月两组西安大略和 麦克马斯特大学骨关节炎指数（WOMAC）各项评分均降低，美国膝关节协会评分（KSS）各项评分及膝关节活动度 （ROM）均升高，且研究组术后 6 个月 ROM 高于对照组，但两组间 WOMAC 评分、KSS 评分比较，差异无统计学意义。 两组患者术后随访 6 个月，均未发生手术相关并发症。结论：机器人辅助全膝关节置换术治疗膝骨关节炎具有较好 效果，可有效缓解术后疼痛，提高治疗效果，安全性较好。

Objective: To investigate the clinical effect of robot-assisted total knee arthroplasty (TKA) in the treatment of patients with knee osteoarthritis. Methods: 92 patients with knee osteoarthritis admitted to the four hospitals in Xi’an from June 2020 to June 2023 were selected for prospective study. They were divided into the study group and the control group using a random number table method, with 46 cases in each group. Conventional TKA was performed in the control group, and robot-assisted TKA was performed in the study group. The surgical indexes, Hb, Hct, pain level, imaging evaluation indexes, knee joint function, and complications between the two groups were compared. Results: Compared with the control group, the study group had a longer operative time. Compared with that before surgery, Hb and Hct levels were both decreased in the two groups after surgery, but the difference between the two groups was not statistically significant. Compared with that 8 h after surgery, visual analogue scales (VAS) scores of the two groups were both decreased at 16 h and 24 h after surgery, and more lower at 24 h after surgery, and they were lower in the study group than those in the control group at 8 h and 16 h after surgery. Compared with that before surgery, the medial proximal tibial angle (MPTA) and lateral distal femoral angle (LDFA) were raised, and the hip-knee-ankle angle (HKA) excursion and the joint-line convergence angle (JLCA) were reduced in the two groups at 6 months after surgery, and the HKA excursion and JLCA were lower in the study group than those in the control group. The Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) scores were lower in the two groups at 6 months after surgery, while the knee society score (KSS) scores and range of motion (ROM) were higher, and ROM was higher in the study group than that in the control group at 6 months after surgery, but the differences in WOMAC and KSS scores were not statistically significant between the two groups. There were no surgical-related complications in both groups during the 6-month follow-up. Conclusion: Robot-assisted TKA has good effect in treating knee osteoarthritis, which can effectively alleviate postoperative pain, improve the therapeutic effect with better safety.

收稿日期：2024-02-29  录用日期：2024-04-16 

Received Date: 2024-02-29  Accepted Date: 2024-04-16 

基金项目：陕西省重点研发计划项目（2022SF-100） 

Foundation Item: Key R&D Project of Shaanxi Province (2022SF-100) 

通讯作者：陈安强，Email：15129793508@163.com 

Corresponding Author: CHEN Anqiang, Email: 15129793508@163.com 

引用格式：鲁军伟，韩亮，韩帅，等 . 机器人辅助全膝关节置换术治疗膝骨关节炎临床效果研究 [J]. 机器人外科学杂志（中英文）， 2024，5（5）：783-788. 

Citation: LU J W, HAN L, HAN S, et al. Clinical effect of robot-assisted total knee arthroplasty in the treatment of knee osteoarthritis[J]. Chinese Journal of Robotic Surgery, 2024, 5(5): 783-788.

[1] Liu C Y, Tu J F, Lee M S, et al. Is acupuncture effective for knee osteoarthritis? A protocol for a systematic review and metaanalysis[J].BMJ Open, 2022, 12(1): e052270. 

[2] 邢路瑶 , 胡娟娟 , 周琦 , 等 . 机器人辅助全膝关节置换术的护理 配合 [J]. 护理学杂志 , 2022, 37(6): 40-43. 

[3] 夏增兵 , 胡文林 , 吴荣 , 等 . 机器人辅助全膝关节置换术的近期 疗效与安全性评价 [J]. 中国医刊 , 2023, 58(3): 276-279. 

[4] 安浩铭 , 平航宇 , 李海峰 , 等 . 国产“鸿鹄”骨科手术机器人辅 助与传统人工全膝关节置换术近期疗效比较研究 [J]. 中国修复 重建外科杂志 , 2023, 37(4): 404-409. 

[5] 邱贵兴 . 骨关节炎诊治指南 [C].//2011 全国骨关节创伤学术研 讨会论文集 , 2011: 1-2. 

[6] 杨天翔 , 张博文 , 张晋宁 , 等 . 单髁与全膝关节置换术治疗膝单 间室骨关节炎的早期疗效比较 [J]. 临床骨科杂志 , 2023, 26(1): 47-51. 

[7] 汪东亮 , 董礼 , 刘斌 . 视觉模拟评估法对 AECOPD 患者症状感 知的适用性研究 [J]. 临床肺科杂志 , 2023, 28(1): 25-29. 

[8] 严攀 , 刘波 , 阴俊 , 等 . 西安大略和麦克马斯特大学骨关节炎指 数用于膝退行性骨关节炎患者评定的反应度研究 [J]. 中国康复 医学杂志 , 2016, 31(2): 215-216. 

[9] Gacto-Sánchez M, Lozano-Meca J A, Lozano-Guadalajara J V, et al. Concurrent validity of the 2-and 6-minute walk test in knee osteoarthritis[J].Knee, 2023, 43(4): 34-41. 

[10] 张鹏远 , 马明阳 , 孔祥朋 , 等 .MAKO 机器人辅助与传统手工 全膝关节置换术后下肢力线的对比研究 [J]. 骨科 , 2023, 14(2): 155-160. 

[11] 汝跃方 , 何荣新 .Mako 机器人辅助全膝关节置换术在膝骨性关 节炎的早期应用 [J]. 中国骨伤 , 2023, 36(2): 133-139. 

[12] 张颖 , 韩慧 , 刘烨 , 等 .MAKO 机器人辅助下全膝关节置换的 手术室标准护理流程探讨 [J]. 中日友好医院学报 , 2022, 36(5): 295-297. 

[13] 荣根祥 , 张金陵 , 张弘景 , 等 . 机器人辅助全膝关节置换术治 疗膝骨关节炎的临床研究 [J]. 实用骨科杂志 , 2022, 28(11): 976- 981. 

[14] 杨程 , 张彦 , 朱铁 , 等 . 腓骨截骨与运动疗法联合治疗内翻型 膝骨关节炎效果分析 [J]. 中华老年骨科与康复电子杂志 , 2023, 09(1): 28-32. 

[15] 董跃福 , 宋群山 , 徐祥钧 , 等 . 全膝关节置换术中 Pie-crusting 技术治疗膝骨关节炎内翻畸形的临床研究 [J]. 中国医药导报 , 2022, 19(6): 85-88. 

[16] GUO Z, WANG J W, LI Z L, et al. Protocol to establish auxiliary diagnostic model for knee osteoarthritis functional testing equipment[J].J Tradit Chin Med, 2023, 43(2): 379-385. 

[17] 高峰 , 徐锋 , 吴晓峰 , 等 . 全膝关节置换术治疗老年膝骨关节炎 的临床疗效 [J]. 临床骨科杂志 , 2023, 26(2): 193-197. 

[18] 胡泽森 , 夏磊 , 郝非凡 , 等 . 间隙平衡技术与测量截骨技术在内 翻膝骨性关节炎患者全膝关节置换术中的应用效果比较 [J]. 新 乡医学院学报 , 2022, 39(12): 1145-1149, 1154. 

[19] 钱春晓 , 储旭东 , 过锡民 , 等 . 全膝关节置换术治疗膝骨关节炎 合并固定性髌骨脱位对 HSS、VAS 评分及股骨胫骨角的影响 [J]. 重庆医学 , 2022, 51(S02): 240-242. 

[20] 杨勇 , 郭庆华 , 陈志辉 . 膝骨关节炎合并化脓性关节炎患者感 染控制后行全膝关节置换术的疗效观察 [J]. 新乡医学院学报 , 2022, 39(4): 358-361. 

[21] 冯帅 . 膝关节单髁置换在膝内侧间室骨关节炎患者中的疗效 及对关节功能、关节相关参数的影响 [J]. 中外医学研究 , 2023, 21(14): 9-13.