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功能学对线机器人辅助膝关节置换术研究进展
Hits: 366   Download times: 157   Received:June 16, 2023    
作者Author单位UnitE-Mail
杨永泽 YANG Yong-ze 甘肃省人民医院骨科四病区, 甘肃 兰州 730000 Orthopedic Ward Four, Gansu Provincial People's Hospital, Lanzhou 730000, Gansu, China  
程晴灏 CHENG Qing-hao 甘肃省人民医院骨科四病区, 甘肃 兰州 730000 Orthopedic Ward Four, Gansu Provincial People's Hospital, Lanzhou 730000, Gansu, China  
张安任 ZHANG An-ren 甘肃省人民医院骨科四病区, 甘肃 兰州 730000 Orthopedic Ward Four, Gansu Provincial People's Hospital, Lanzhou 730000, Gansu, China  
邱怡 QIU Yi 甘肃省人民医院骨科四病区, 甘肃 兰州 730000 Orthopedic Ward Four, Gansu Provincial People's Hospital, Lanzhou 730000, Gansu, China  
郭洪章 GUO Hong-zhang 甘肃省人民医院骨科四病区, 甘肃 兰州 730000 Orthopedic Ward Four, Gansu Provincial People's Hospital, Lanzhou 730000, Gansu, China g_hz@163.com 
期刊信息:《中国骨伤》2023年36卷,第11期,第1106-1110页
DOI:10.12200/j.issn.1003-0034.2023.11.019
基金项目:甘肃省自然科学基金(编号:20JR10RA358)
膝关节的正确对线被认为是决定全膝关节置换术(total knee arthroplasty,TKA)后长期预后的最具影响的因素之一,为了达到正确的对准目标,已经建立了许多不同的对准理念和外科技术,如机械对线(mechanical alignment,MA)、运动学对线(kinematic alignment,KA)和功能学对线(functional alignment,FA)3种对线技术各有特点,MA注重实现肢体的中性对齐,伸展和屈曲时平行且相等的骨间隙;KA以恢复患者的天然关节线为目标,使关节水平和角度正常并使生理性软组织平衡得到改善,努力重现接近正常的膝关节功能;其中随着机器人辅助手术技术而发展起来的功能学对线FA,功能学对线是一种相对较新的对齐理念,它不仅考虑到机体的下肢生理对齐,而且还旨在实现屈伸平衡,同时尊重原生软组织包膜。既做到了术中精确的恢复原位关节线的平面和斜度,又兼顾了软组织平衡,是一种更佳的对线方式。因此,正确构建患者下肢力线,有助于恢复膝关节功能、缓解疼痛症状和延长假体使用寿命具有十分重要的意义。但与传统 TKA 相比,机器人辅助 FA-TKA 手术时间延长,这意味着术后感染发生概率可能性会更大,并且目前大多数研究报道的FA技术都是短期结果,对患者远期疗效尚不清楚,因此,需要长期的研究结果来支持这项技术的应用。
[关键词]:功能学对线  机器人辅助  全膝关节置换术
 
Research progress of functional alignment robot assisted knee replacement
Abstract:The correct alignment of the knee joint is considered to be one of the most influential factors in determining the long-term prognosis after total knee arthroplasty(TKA). In order to achieve the correct alignment goal,many different alignment concepts and surgical techniques have been established. For example,mechanical alignment(MA),kinematic alignment(KA) and functional alignment(FA) have their own characteristics. MA focuses on achieving neutral alignment of the limbs,parallel and equal bone gaps during stretching and flexion. KA aims to restore the patient 's natural joint line,make the joint level and angle normal and improve the physiological soft tissue balance,and strive to reproduce the normal knee function;among them,functional alignment(FA) developed with robot-assisted surgery technology is a relatively new alignment concept. It not only considers the alignment of the body,but also aims to achieve flexion and extension balance,while respecting the native soft tissue capsule. It not only restores the plane and slope of the in situ joint line accurately during the operation,but also takes into account the balance of soft tissue,which is a better alignment method. Therefore,it is of great significance to correctly construct the lower limb force line of patients,which is helpful to restore knee joint function,relieve pain symptoms and prolong the service life of prosthesi. However,compared with traditional TKA,the operation time of robot-assisted FA-TKA is prolonged,which means that the probability of postoperative infection will be greater. At present,most studies of FA technology report short-term results,and the long-term efficacy of patients is not clear. Therefore,long-term research results are needed to support the application of this technology. Therefore,the author makes a review on the research status of functional alignment.
KEYWORDS:Functional alignment  Robotic surgical procedures  Arthroplasty,replacement,knee
 
引用本文,请按以下格式著录参考文献:
中文格式:杨永泽,程晴灏,张安任,邱怡,郭洪章.功能学对线机器人辅助膝关节置换术研究进展[J].中国骨伤,2023,36(11):1106~1110
英文格式:YANG Yong-ze,CHENG Qing-hao,ZHANG An-ren,QIU Yi,GUO Hong-zhang.Research progress of functional alignment robot assisted knee replacement[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(11):1106~1110
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