动态关节平衡在机器人辅助全膝关节整形术中提供一致的差距预测
Daisuke Fukui1,2, Daisuke Nishiyama3,4, Manabu Yamanaka3
1Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan. fukui52722@gmail.com.
Journal of robotic surgery
|September 5, 2025
概括
在机器人辅助全膝关节整形手术 (RATKA) 中,动态关节平衡 (DJB) 可靠地估计虚空隙 (VG),但FG通常超过VG,特别是在曲方面. DJB是一个独立于外科经验的宝贵工具.
科学领域:
- 骨科手术
- 医疗中的机器人
- 生物机械工程
背景情况:
- 动态关节平衡 (DJB) 在机器人辅助全膝关节整形手术 (RATKA) 中至关重要,以预测骨切除前的软组织平衡.
- 虚拟差距 (VG) 估计是DJB的关键组成部分,但其预测最终差距 (FG) 的准确性需要进一步调查.
研究的目的:
- 在RATKA中评估手术内测量的虚拟间隙 (VG) 和植入后的最终间隙 (FG) 之间的相关性.
- 评估DJB在FG预测中的准确性,并确定影响差异的因素.
- 研究RATKA中与DJB相关的学习曲线.
主要方法:
- 使用MAKO系统对77名膝盖 (61名患者) 进行回顾性分析.
- 在骨切除前,在四个位置 (中间/侧面,10度延伸,90度曲) 记录VG测量.
- 植入后测量FG;分析VG-FG相关性和差异 (≥3毫米),以及植入物对齐和学习曲线效应.
主要成果:
- 在所有测量点中观察到VG和FG之间的中度至强度相关性 (r=0.50-0.71).
- FG一直高估了VG (平均值为0.6-1.3毫米),侧向曲间隙的差异更大.
- 间隙误差≥3mm在曲 (8. 4%) 比延伸 (1. 3%) 显著更频繁;与对齐误差或学习曲线无关.
结论:
- 基于DJB的VG估计为RATKA提供了可靠的手术内参考,独立于手术经验.
- 过度估计FG,特别是曲,强调了需要改进的DJB建模或测量技术.
- DJB的稳定性支持其在全膝关节整形中标准化软组织平衡的作用.
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