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Title: [Biomechanical analysis of sitting-up movement of knee joint after robot-assisted unicompartmental knee arthroplasty].
Author: Du G, Li Z, Lao S, Urish K.
Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2021 Oct 15; 35(10):1259-1264. PubMed ID: 34651478.
Abstract:
OBJECTIVE: To investigate the effect of Navio robot-assisted unicompartmental knee arthroplasty (UKA) on the biomechanics of knee joint during sitting-up movement, and to determine whether UKA can maintain the biomechanical characteristics of knee joint. METHODS: The clinical data of 8 patients with medial compartment osteoarthritis treated with medial fixed platform of Navio robot-assisted UKA between January 2018 and January 2019 and had the complete follow-up data were retrospectively analyzed. There were 4 males and 4 females; the age ranged from 58 to 67 years, with an average of 62.3 years. The disease duration was 6-18 months, with an average of 13 months. The varus deformity ranged from 4° to 6°, with an average of 5°; the knee flexion range of motion was 0°-130°, with an average of 110°. All patients had no extension limitation. The imaging data of bilateral knees during sitting-up movement were collected by biplane C-arm X-ray machine at 3 weeks before operation and 7 months after operation. The three-dimensional models of femur and tibia were established by dual-energy CT scanning, and the three-dimensional models of femur and tibia were matched and synchronized with the femur and tibia in X-ray film by automatic matching tracer software. The biomechanical parameters of femur and tibia were measured, including internal rotation/external rotation, varus/valgus, forward/backward displacement of medial and lateral tibia contact center, and lateral compartment joint space. RESULTS: Eight patients were followed up 5-7 months, with an average of 6.4 months. In the comparison of the affected side before and after operation, except for the difference of varus/valgus which was significant ( t=4.959, P=0.002), the differences in other indicators was not significant ( P>0.05). There were significant differences in varus/valgus and internal rotation/external rotation between healthy and affected sides at 3 weeks before operation ( P<0.05), and the differences in other indicators was not significant ( P>0.05). At 7 months after operation, the difference in the forward and backward displacement of medial tibia contact center was significant ( t=3.798, P=0.007), and the differences in other indicators was not significant ( P>0.05). CONCLUSION: UKA can effectively correct the varus and valgus of the knee joint, and restore the rotational biomechanical characteristics of the affected knee joint. It does not affect the establishment of the lateral compartment joint space, but the medial and lateral tibia contact center still changes. 目的: 探讨 Navio 机器人系统辅助膝关节单髁置换术（unicompartmental knee arthroplasty，UKA）对于坐起动作时膝关节生物力学的影响，明确 UKA 能否维持膝关节的生物力学特性。. 方法: 回顾分析 2018 年 1 月—2019 年 1 月接受 Navio 机器人系统内侧固定平台 UKA 治疗，并且获完整随访的 8 例内侧间室骨关节炎患者临床资料。男 4 例，女 4 例；年龄 58～67 岁，平均 62.3 岁。病程 6～18 个月，平均 13 个月。内翻畸形 4°～6°，平均 5°；膝关节屈曲活动度 0°～130°，平均 110°；所有患者均无伸直受限。术前 3 周及术后 7 个月采用双平面 C 臂 X 线机收集患者坐起动作时双侧膝关节影像资料；通过双能 CT 扫描建立股骨、胫骨三维模型，自动匹配示踪软件将股骨、胫骨三维模型与 X 线片中的股骨、胫骨相匹配并同步。测量股骨、胫骨的生物力学参数，包括内旋/外旋、内翻/外翻、内侧及外侧间室接触中心点前后位移、外侧间室距离。. 结果: 8 例患者获随访，随访时间 5～7 个月，平均 6.4 个月。患侧手术前后比较，除内翻/外翻差异有统计学意义（ t=4.959， P=0.002）外，其余指标差异均无统计学意义（ P>0.05）。健患侧间比较，术前 3 周内翻/外翻、内旋/外旋差异有统计学意义（ P<0.05），其余指标差异均无统计学意义（ P>0.05）；术后 7 个月内侧间室接触中心点前后位移差异有统计学意义（ t=3.798， P=0.007），其余指标差异均无统计学意义（ P>0.05）。. 结论: UKA 可以有效矫正膝关节内外翻畸形，恢复膝关节旋转生物力学特性，且不影响外侧间室间隙的建立，但内外侧间室的接触中心仍有变化。.

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