摘要
目的探讨国产骨科手术机器人系统应用于髓芯减压植骨术治疗早期股骨头坏死的临床效果。方法回顾性分析2016年6月至2018年2月在烟台山医院骨关节科因国际骨循环研究会（ARCO）Ⅱ期股骨头坏死行骨科机器人导航辅助下股骨头髓芯减压植骨术的9例（16髋）患者资料。其中男性7例，女性2例，平均年龄44.6岁（范围：28～60岁）。所有手术由同一名术者使用骨科机器人导航系统辅助置入导针，并使用自主设计的机器人配套手术工具完成减压及植骨操作。比较患者术前与术后末次随访的Harris髋关节评分及视觉模拟评分（VAS）。记录术中X线透视总次数、导针置入过程及减压植骨操作过程中X线透视次数。正态分布的计量资料以±s表示，组间比较采用配对样本t检验。结果随访时间（12.7±3.5）个月（范围：6～18个月），9例患者均获得随访，其中4例患者在末次随访时出现股骨头表面塌陷，其中1例行全髋关节置换治疗。假体生存率为12/16，其中ARCO Ⅱa、Ⅱb、Ⅱc期假体生存率分别为1/1、2/2、9/13。术前Harris髋关节评分（70.0±3.8）分，末次随访为（88.3±1.9）分（t＝16.81，P＝0.000）。术前髋关节VAS为（3.7±0.7）分，末次随访为（0.9±0.6）分（t＝13.49，P＝0.000）。术中总X线透视次数（15.9±2.5）次，成功置入导针过程中X线透视（5.8±1.2）次，减压、植骨操作中X线透视（10.1±1.7）次。结论国产骨科手术机器人导航系统应用于早期股骨头坏死髓芯减压植骨手术效果较满意。
ObjectiveTo evaluate the effects of orthopedic robot navigation system used in core decompression combined with bone graft surgery for osteonecrosis of the femoral head （ONFH）.
MethodsA retrospective analysis was performed on 9 patients （16 hips） underwent core decompression surgery combined with bone graft treatment for early ONFH in ARCO Ⅱat Department of Osteoarthropathy, Yantaishan Hospital from June 2016 to February 2018.There were 7 males and 2 females, aged 44.6 years （range： 28-60 years）. All surgery procedures were completed by the same doctor under the navigation of orthopedic surgery robot using the specific designed tools. The preoperative and postoperative Harris Hip Score and visual analogue score were compared and the time of intraoperative X-ray fluoroscopy was recorded.ResultsThe mean follow-up period was （12.7±3.5）months （range： 6-18 months）. Four cases of treatment failure were observed in 16 hips at the last follow-up and the hip survival rate was 12/16.In stage ARCO Ⅱa, Ⅱb and Ⅱc, the survival rate was 1/1, 2/2, and 9/13.The Harris Hip Score （88.3±1.9 vs.70.0±3.8, t=16.81, P=0.000） and visual analogue score （3.7±0.7 vs. 0.9±0.6, t=13.49, P=0.000） were improved significantly at the last follow-up compared with preoperative value. The total times of intraoperative X-ray fluoroscopy were 15.9±2.5, including 5.8±1.2 before the insertion of the guiding wire and 10.1±1.7 after the insertion of the guiding wire.ConclusionsThe domestic orthopedic surgery robot can be applied successfully in the core decompression combined with bone graft surgery for ONFH . It is less invasive with less fluoroscopy time and better bone graft effects.
作者
赵宇驰
曲文庆
张树栋
Zhao Yuchi;Qu Wenqing;Zhang Shudong(Department of Osteoarthropathy,Yantaishan Hospital,Yantai 264001,China)
出处
《中华外科杂志》
CAS
CSCD
北大核心
2018年第11期849-853,共5页
Chinese Journal of Surgery
关键词
股骨头坏死
治疗结果
机器人导航
髓芯减压
Femur head necrosis
Treatment outcome
Robot navigation
Core decompression
