目的：评价个性化冠状位对线在全膝关节置换术（TKA）治疗膝骨关节炎中的临床效果。方法：检索万方、维普、中国知 网、中国生物医学文献数据库、PubMed、The Cochrane Library、Web of Science、Embase，对比个性化对线与经典机械对线（MA） 全膝关节置换术治疗膝骨关节炎的随机对照试验（RCT），个性化对线技术包括运动学对线（KA）、限制性运动学对线（rKA）、 改良机械对线（aMA）和功能对线（FA），时间范围为从建库开始至 2024 年 2 月。运用 Microsoft Excel 2021 和 RevMan 5.3 软件进行 Meta 分析。结果：共纳入 11 项符合条件的 RCT 研究。KA 组术后 3 个月牛津大学膝关节评分、术后 6 个月美国膝 关节协会评分（American Knee Society Score，KSS）膝评分、术后 2 年 KSS 功能评分显著优于 MA 组，与 MA 组相比，术后 5 年及以上假体翻修率差异无统计学意义。rKA 组术后 1 年 KSS 总分显著优于 MA 组。FA 的发展与机器人辅助技术密切相关， FA 组术后 72 h 内视觉模拟评分法（VAS）疼痛评分显著低于 MA 组。未检索到 aMA 与 MA 的 RCT 研究。结论：相较于经典 的机械对线技术，个性化对线技术在术后早期随访中展现出更好的功能结局，长期随访中并未出现更高的假体翻修率。机器 人辅助技术促进了个性化对线技术在全膝关节置换术中的应用，其临床效果有待进一步验证。

Objective: To evaluate the clinical outcomes of personalized coronal alignment in total knee arthroplasty (TKA) for the treatment of knee osteoarthritis. Methods: Wanfang Database, VIP Database, CNKI, China Biology Medicine disc, PubMed, The Cochrane Library, Web of Science, and Embase were searched for comparing the randomized controlled trials (RCT) between personalized alignment and classical mechanical alignment (MA) in total knee arthroplasty for the treatment of knee osteoarthritis. The personalized alignment techniques included kinematic alignment (KA), restricted kinematic alignment (rKA), adjusted mechanical alignment (aMA), and functional alignment (FA), with a timeframe from the creation of databases to February 2024. Meta-analysis was performed using Microsoft Excel 2021 and RevMan 5.3 software. Results: A total of 11 eligible RCTs were included. The Oxford knee scores at 3 months after surgery, the American Knee Society Score (KSS) knee scores at 6 months after surgery, and the KSS functional scores at 2 years after surgery were significantly better in the KA group than those in the MA group, and the difference in the rate of prosthesis revision at 5 years or more after surgery was not statistically significant between the two groups. The total KSS scores at 1 year after surgery was significantly better in the rKA group than those in the MA group. The development of FA was closely related to robot-assisted technology, and the visual analog scale (VAS) scores at 3 d after surgery was significantly lower in the FA group than those in the MA group. No RCT studies comparing aMA with MA was retrieved. Conclusion: Compared with the classical mechanical alignment technique, the personalized alignment technique demonstrated better functional outcomes in early postoperative follow-up and showed no higher rate of prosthesis revision in long-term follow-up. Robot-assisted technology facilitates the use of personalized alignment in TKA, but its clinical effectiveness needs to be further verified.

引用格式：李铭，丁冉，钟子康，等 . 个性化冠状位对线全膝关节置换术临床疗效的 Meta 分析 [J]. 机器人外科学杂志（中英文），2025， 6（2）：187-198. 

Citation: LI M, DING R, ZHONG Z K, et al. Clinical efficacy of personalized coronal alignment in total knee arthroplasty: a Meta-analysis [J].  Chinese Journal of Robotic Surgery, 2025, 6(2): 187-198. 

通讯作者（Corresponding Author）：王卫国（WANG Weiguo），Email：jointwwg@163.com

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