机器人辅助定位股骨隧道在内侧髌股韧带重建术中的应用
Robot-assisted femoral tunnel localization in reconstruction of the medial patellofemoral ligament
张召贺 1方禹舜 2李亚楠 2张绍华 2谈鸿飞 2张青松2
作者信息
- 1. 武汉市第四医院运动医学科,湖北省运动医学中心,武汉 430030;华中科技大学同济医学院附属普爱医院,武汉 430030
- 2. 武汉市第四医院运动医学科,湖北省运动医学中心,武汉 430030
- 折叠
摘要
目的 探讨机器人辅助定位股骨隧道在内侧髌股韧带(MPFL)重建术中的应用效果.方法 回顾性分析2019年1月至2022年1月武汉市第四医院运动医学科收治的36例复发性髌骨脱位需行MPFL重建术的患者资料.男15例,女21例;年龄23.5(18.3,29.0)岁;脱位次数2.5(2.0,3.0)次.根据在MPFL重建术中是否使用机器人辅助定位将患者分为观察组(17例,采用机器人辅助定位股骨隧道重建MPFL)和对照组(19例,采用C型臂X线机术中透视定位股骨隧道重建MPFL).比较两组患者的手术时间、导针定位次数、术后1 d疼痛视觉模拟评分(VAS)、术后1～3d的髌骨倾斜角(PTA)、术后1～3d的股骨隧道中心点与股骨理想Schöttle点的距离,以及末次随访时的膝关节功能Lysholm的膝关节主观评分、国际膝关节评分委员会(IKDC)评分等.结果 两组患者术前一般资料比较差异均无统计学意义(P＞0.05),具有可比性.所有患者术后随访12.0(10.3,13.0)个月.观察组患者的手术时间[(64.1±16.7)min]、导针定位次数[1.0(1.0,2.0)次]、疼痛VAS[2.5(2.0,3.0)分]、股骨隧道插入点与理想插入点间的距离[(4.7±1.2)mm]显著优于对照组患者[(84.2±19.7)min、3.0(2.0,4.0)次、3.5(3.0,4.0)分、(6.1±1.2)mm],差异均有统计学意义(P＜0.05).观察组患者的PTA、Lysholm评分、IKDC评分与对照组患者比较差异均无统计学意义(P＞0.05).结论 机器人辅助定位股骨隧道在MPFL重建术中能够获得满意的疗效.与C型臂X线机术中透视定位相比,机器人辅助定位能够减少导针定位次数,减轻患者术后疼痛程度,提高建立股骨隧道的精准度和效率.
Abstract
Objective To investigate the efficacy of robot-assisted femoral tunnel localization in re-construction of the medial patellofemoral ligament(MPFL).Methods A retrospective study was conduct-ed to analyze the 36 patients who had been admitted to Department of Sports Medicine,The Fourth Hospital of Wuhan between January 2019 and January 2022 due to recurrent patellar dislocation.There were 15 males and 21 females;age:23.5(18.3,29.0)years;number of dislocations:2.5(2.0,3.0).They were stratified into 2 cohorts based on utilization of robot-assistance.In the observation group(17 cases),the femoral tunnel localization was robot-assisted in MPFL reconstruction;in the control group(19 cases),the femoral tunnel lo-calization was guided by C-arm fluoroscopy in MPFL reconstruction.The 2 groups were compared in terms of operation time,frequency of guide wire placement,visual analogue scale(VAS)at postoperative 1 d,patellar tilt angle(PTA)and the disparity between actual femoral tunnel insertion and ideal tunnel insertion point(Schöttle point)at postoperative 1 to 3 d,and Lysholm knee score and International Knee Documentation Com-mittee(IKDC)score at the last follow-up.Results There was no significant difference in the preoperative general data between the 2 groups,showing comparability(P＞0.05).All patients were followed up for 12.0(10.3,13.0)months.In the observation group,the operation time[(64.1±16.7)min],frequency of guide wire placement[1.0(1.0,2.0)times],VAS[2.5(2.0,3.0)points],and disparity between actual femoral tunnel insertion and ideal tunnel insertion point[(4.7±1.2)mm]were significantly better than those in the control group[(84.2±19.7)min,3.0(2.0,4.0)times,3.5(3.0,4.0)points,and(6.1±1.2)mm](P＜0.05).There was no statistical difference between the 2 groups in PTA,Lysholm knee score or IKDC score(P＞0.05).Conclusions The short-term clinical efficacy of robot-assisted femoral tunnel localization is satisfactory in MPFL reconstruction.Compared with the intraoperative C-arm fluo-roscopy,robot-assisted localization can decrease the frequency of guide wire placement,enhance femoral tunnel accuracy and efficiency,and alleviate more postoperative pain for the patients.
关键词
髌骨脱位/韧带,关节/外科手术,计算机辅助/机器人Key words
Patellar dislocation/Ligaments,articular/Surgery,computer-assisted/Robotics引用本文复制引用
出版年
2024
NETL
NSTL
万方数据