机器人辅助全膝关节置换技术的应用与前景.

BACKGROUND: The basic principle of the design of the robot system used for total knee arthroplasty is to combine three-dimensional surgical planning, early warning of danger areas during surgery, real-time data feedback, robot arm assisted osteotomy and other technologies to achieve precision and personalization of total knee arthroplasty, which is exactly its biggest advantage. Therefore, it has become a hot topic in the field of joint surgery in recent years and attracted much attention. OBJECTIVE: To summarize the development status of robotic-assisted total knee arthroplasty in the field of joint surgery and the comparison of advantages and disadvantages with conventional total knee arthroplasty and to prospect the future development of robotic-assisted total knee arthroplasty. METHODS: Relevant articles were searched from PubMed, CNKI, Wanfang and VIP databases by computer. English key words were “robot OR robotic OR robotics OR robotically OR computer, total knee arthroplasty OR total knee replacement, TKA OR TKR”. Chinese key words were “robotic-assisted, computer navigation, total knee arthroplasty”. Finally, 64 articles were included for review and analysis. RESULTS AND CONCLUSION: (1) The robot system used to assist total knee arthroplasty is divided into active, semi-active and passive according to its degree of freedom. The semi-active system, currently widely used in robotic systems, effectively enhances the accuracy and personalization of total knee arthroplasty. However, its high implementation cost and relatively steep learning curve remain key factors to be balanced when promoting its adoption in joint surgery field. (2) Robotic-assisted total knee arthroplasty can achieve precise osteotomy and correct placement of prosthesis in local three-dimensional space of the knee joint. It has been widely proven that it can provide better accuracy of prosthesis implantation, reduce imaging abnormalities, obtain good soft tissue balance during the operation, and ultimately improve the motion and functional status of the knee joint after the operation. (3) However, the current robotic-assisted system still has objective shortcomings, including the problem of learning curve between different robot devices and operators, additional installation and maintenance costs, and potential complications related to robot surgery. Therefore, whether it can truly benefit the medical system and patients still needs to be proven by long-term research, and the robotic-assisted system also needs to be further improved substantially. (4) Robotic-assisted total knee arthroplasty technique is still in the preliminary research stage in clinical practice and has not been widely applied. To better define the usage of robotic-assisted total knee arthroplasty and enhance its clinical procedural standards and safety, refining these aspects will become a focal point of future research on robotic-assisted total knee arthroplasty. [ABSTRACT FROM AUTHOR]