[1]卞恒杰,周宇,王睿,等.机器人辅助膝关节置换与人工膝关节置换早期疗效对比及差异分析[J].中国中医骨伤科杂志,2026,34(08):46-53.[doi:10.20085/j.cnki.issn1005-0205.260807]
　BIAN Hengjie,ZHOU Yu,WANG Rui,et al.Comparison and Difference Analysis of Early Curative Effect between Robot Assisted and Artificial Knee Arthroplasty[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2026,34(08):46-53.[doi:10.20085/j.cnki.issn1005-0205.260807]
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机器人辅助膝关节置换与人工膝关节置换早期疗效对比及差异分析()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第34卷
期数:
2026年08期
页码:
46-53
栏目:
临床研究
出版日期:
2026-08-10

文章信息/Info

Title:
Comparison and Difference Analysis of Early Curative Effect between Robot Assisted and Artificial Knee Arthroplasty
文章编号:
1005-0205(2026)08-0046-08
作者:
卞恒杰1; 周宇1; 王睿1; 王津2△; 李同林1; 周飞1; 李鑫1; 李义凯3; 孙玉明4
1南京中医药大学附属南京市中西医结合医院(南京,210014)
2上海交通大学附属上海市第六人民医院
3南方医科大学南方医院
4南京中医药大学附属医院
Author(s):
BIAN Hengjie1; ZHOU Yu1; WANG Rui1; WANG Jin2△; LI Tonglin1; ZHOU Fei1; LI Xin1; LI Yikai3; SUN Yuming4
1Nanjing Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Nanjing University of Chinese Medicine,Nanjing 210014,China; 2Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University,Shanghai 200233,China; 3Nanfang Hospital,Southern Medical University,Guangzhou 510515,China; 4Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China.
关键词:
人工智能;  机器人;  膝关节置换;  早期疗效
Keywords:
artificial intelligence;  robot;  knee arthroplasty;  early and mid-term outcomes
分类号:
R684.3
DOI:
10.20085/j.cnki.issn1005-0205.260807
文献标志码:
A
摘要:
目的:对比机器人辅助膝关节置换与人工膝关节置换早期临床疗效,探讨机器人辅助膝关节置换的优势及存在的问题。方法:回顾2024年9月至2025年2月全膝关节置换手术病例,其中Mako辅助组82例,Cori辅助组69例,人工组86例,根据手术前及术后初期随访资料,通过手术前后疼痛视觉模拟量表(VAS)评分、膝关节活动范围(ROM)、髋-膝-踝角(HKA)、美国特种外科医院膝关节功能评分(HSS评分)等指标对比三组患者临床疗效。结果:三组患者术前基础资料差异无统计学意义(P>0.05),三组患者全膝关节置换术后均取得良好的临床疗效,Mako和Cori机器人辅助的全膝关节置换术后2周临床效果更好,表现为疼痛更轻(VAS评分分别为Mako辅助组(3.1±0.3)分,Cori辅助组(3.6±0.5)分,人工组(4.3±0.6)分)、活动度更大(膝关节活动范围分别为Mako辅助组115.2°±6.4°,Cori辅助组109.5°±7.6°,人工组101.7°±8.3°)、下肢力线恢复更理想(髋-膝-踝角分别为Mako辅助组177.2°±1.8°,Cori辅助组176.5°±2.6°,人工组172.3°±3.4°)、功能更好(HSS评分分别为Mako辅助组(57.2±3.4)分,Cori辅助组(53.6±4.5)分,人工组(49.4±4.3)分),差异有统计学意义(P<0.05)。术后3个月时三组患者VAS评分、膝关节活动范围、髋-膝-踝角、膝关节HSS评分同样表现为机器人辅助组较人工组效果更好,差异有统计学意义(P<0.05)。结论:机器人辅助全膝关节置换术可做到软组织平衡、截骨量、下肢力线及运动轨迹数字可视化,患者术后在疼痛及关节活动度方面恢复得更快,较人工置换具有精度更高、骨损伤更小、发挥更稳定等优点。
Abstract:
Objective:To compare the early clinical efficacy of robot assisted and artificial knee arthroplasty and to explore the advantages and existing problems of robot assisted knee arthroplasty.Methods:Reviewing the cases of total knee arthroplasty(TKA)surgery from September 2024 to February 2025,including 82 cases assisted by Mako,69 cases assisted by Cori,and 86 cases assisted by artificial surgery,the clinical efficacy of the three groups was compared based on the initial follow-up data before and after surgery using indicators such as visual analog scale(VAS)scores,range of motion(ROM),hip knee ankle(HKA)angle,and knee joint function score from the American Hospital for Special Surgery(HSS scores).Results:There was no significant difference in the preoperative baseline data among the three groups(P>0.05).All the three groups achieved good clinical efficacy after TKA.The clinical effect of TKA assisted by Mako and Cori robot was better 2 weeks after TKA,with lighter pain(VAS scores were(3.1±0.3)points in Mako group,(3.6±0.5)points in Cori group,(4.3±0.6)points in artificial group),and greater activity(ROM was 115.2°±6.4° in Mako group,109.5°±7.6° in Cori group,101.7°±8.3° in artificial group),and better recovery of lower limb force line(HKA angle was 177.2°±1.8° in Mako group,176.5°±2.6° in Cori group,172.3°±3.4° in artificial group),and the function was better(HSS scores were(57.2±3.4)points in Mako group,(53.6±4.5)points in Cori group,(49.4±4.3)points in artificial group),the difference was statistically significant(P<0.05).At 3 months after operation,the VAS score,ROM,HKA angle and knee HSS score of the three groups also showed that the robotic group achieved better outcomes than the artificial group,and the difference was statistically significant(P<0.05).Conclusion:Robot assisted TKA can achieve the digital visualization of soft tissue balance,osteotomy volume,lower limb force line and motion trajectory.Patients recover faster in pain and joint range of motion after operation.Compared with artificial TKA,it has the advantages of higher accuracy,less bone damage and more stable performance.

参考文献/References:

[1] 康俊峰,揭立士,廖太阳,等.膝痹宁Ⅱ治疗寒湿痹阻型膝骨关节炎的随机对照研究[J].中国中医骨伤科杂志,2025,33(1):27-32.
[2] 乔桦,何锐,张经纬,等.机器人辅助全膝关节置换术的多中心临床研究[J].中华骨科杂志,2023,43(1):23-30.
[3] 王坤正.国产人工智能与骨科机器人在关节置换手术中的应用现状与前景[J].中华骨科杂志,2023,43(1):1-4.
[4] 国家卫生计生委公益性行业科研专项《关节置换术安全性与效果评价》项目组,中华医学会骨科学分会关节外科学组,中国医疗保健国际交流促进会骨科分会关节外科委员会.中国髋、膝关节置换术加速康复-围术期管理策略专家共识[J].中华骨与关节外科杂志,2016,9(1):1-9.
[5] MITCHELL J,WANG J,BUKOWSKI B,et al.Relative clinical outcomes comparing manual and robotic-assisted total knee arthroplasty at minimum 1-year follow-up[J].HSS Journal:the Musculoskeletal Journal of Hospital for Special Surgery,2021,17(3):267-273.
[6] SIRES J D,CRAIK J D,WILSON C J,等.Mako机器人辅助下全膝关节置换术截骨精度[J].临床骨科杂志,2022,25(1):71.
[7] FONTALIS A,KAYANI B,ASOKAN A,et al.Inflammatory response in robotic-arm-assisted versus conventional jig-based TKA and the correlation with early functional outcomes:results of a prospective randomized controlled trial[J].Journal of Bone and Joint Surgery,2022,104(21):1905-1914.
[8] KHLOPAS A,SODHI N,HOZACK W J,et al.Patient-reported functional and satisfaction outcomes after robotic-arm-assisted total knee arthroplasty:early results of a prospective multicenter investigation[J].The Journal of Knee Surgery,2020,33(7):685-690.
[9] 张子安,张海宁,李海燕,等.机器人辅助技术在全膝关节置换手术中的应用[J].中国矫形外科杂志,2020,28(11):937-941.
[10] 刘宁宁,王程,耿霄,等.机器人辅助与传统全膝关节置换术早期功能及患者满意度的比较[J].中国微创外科杂志,2024,24(8):545-552.
[11] 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.
[12] DECKEY D G,ROSENOW C S,VERHEY J T,et al.Robotic-assisted total knee arthroplasty improves accuracy and precision compared to conventional techniques[J].The Bone & Joint Journal,2021,103-B(6 SA):74-80.
[13] 刘杠,李国庆,汪洋,等.MAKO机器人辅助全膝关节置换术的早期临床疗效[J].中华骨与关节外科杂志,2023,16(3):232-238.
[14] 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.
[15] ONGGO J R,ONGGO J D,DE STEIGER R,et al.Robotic-assisted total knee arthroplasty is comparable to conventional total knee arthroplasty:a meta-analysis and systematic review[J].Archives of Orthopaedic and Trauma Surgery,2020,140(10):1533-1549.
[16] 卜延民,赵慧雯,郑得志,等.关节置换术机器人手术系统的现状及发展趋势[J].中国矫形外科杂志,2024,32(19):1780-1785.
[17] 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.
[18] 中华医学会骨科学分会关节外科学组.机器人辅助关节置换术操作规范(草案)[J].中华骨与关节外科杂志,2024,17(9):769-780.
[19] 张帅,孔祥朋,柴伟.2021年度关节外科手术机器人临床应用盘点[J].骨科,2022,13(6):562-567.
[20] 张成,李超,韩向东,等.骨科手术机器人临床应用综述[J].医疗卫生装备,2021,42(1):97-101.
[21] 徐溢明,赵天昊,翁习生.机器人辅助髋膝关节置换术发展现状[J].中华骨与关节外科杂志,2022,15(8):633-640.
[22] 高宇,翟吉良,丁大伟,等.人工智能在骨科手术机器人中的应用与展望[J].中华骨与关节外科杂志,2022,15(2):155-160.
(收稿日期:2025-09-07)

备注/Memo

备注/Memo:
基金项目:国家中医药管理局监测统计中心中医药监测统计研究课题(2025JCTJC155)
江苏省中医药科技发展计划面上项目(MS2022045)
江苏省省级中医重点专科(Ⅱ类)建设项目(苏中医医政〔2023〕5号)
南京市中医药传承创新发展示范试点项目-南京市市级柔性人才引进项目(李义凯岐黄学者工作室)(宁卫财务〔2024〕49号)
南京市卫生科技发展专项(YKK22186,ZKX23058)
△通信作者 E-mail:215580038@qq.com
更新日期/Last Update: 2026-08-15