Senile knee osteoarthritis is a common and frequently-occurring disease in the elderly. The cartilage in the knee joint is worn out due to long-term use, and the cartilage basically does not have the ability to regenerate and repair, so the disease is irreversible. When the cartilage in the knee joint is severely worn and conservative treatments such as oral anti-inflammatory analgesics, physiotherapy, and intra-articular injection are ineffective, surgery is the only and effective treatment method.
The knee joint is divided into medial and lateral compartments. 50%-60% of patients have unilateral compartment disease. In most cases, only the damaged side needs to be repaired. Repair can achieve the purpose of treatment. The precise operation of traditional unicondylar knee surgery has always been a major challenge in the industry. In the past half month, the team of Professor Tu Yihui from the Joint Surgery Department of Yangpu Hospital Affiliated to Tongji University has completed several cases of robot-assisted unicondylar knee replacement surgery. More precise and smarter solutions for knee arthritis patients. The successful operation of this operation marks that the elderly knee arthritis has entered the era of robotic treatment, and the operation mode has entered the era of intelligence.
65-year-old Ms. Wang recently underwent robotic surgery for unicondylar replacement. The patient’s right knee joint pain aggravated before the operation, and the patient had difficulty walking for more than 2 years, and his normal life was affected. The X-ray film showed that the medial space of the right knee was narrow, the bones were touching the bones, and the “O”-shaped leg was typical of senile osteoarthritis. After 1 hour and 10 minutes, Professor Tu Yihui’s team successfully completed the robotic surgery, and the patient did not feel any discomfort after the operation.
Conventional knee unicondylar replacement surgery requires high technical requirements, is difficult to operate, and has large prosthesis position variability. The robotic surgery system retains the minimally invasive characteristics of conventional surgery, does not expand the surgical incision, and does not increase trauma; based on the preoperative 3D CT reconstruction of the lower limbs, the computer sets a safe area for operation, avoiding the medial collateral ligament and the ligament. The injury of the anterior cruciate ligament also avoids the damage to the blood vessels and nerves on the back of the knee joint; the computer also selects the size of the prosthesis, determines how much to remove the worn bone, and installs the prosthesis through the three-dimensional CT imaging of the lower extremity. Personalized and precise osteotomy, standard prosthesis placement and optimal prosthesis matching are expected to improve the survival rate of the prosthesis and solve life-long problems with one operation. Combining the operation with the concept of rapid recovery, the patient will be able to achieve the next day after the operation. can be discharged.
The robotic-assisted knee unicondylar replacement surgery system consists of a robotic arm, a main console, a navigation console, surgical power tools and surgical software. The computer-aided navigation system can operate and perform surgery precisely based on accurate data. It has the advantages of repeatability, stability, high precision, and fatigue resistance. It can ensure that doctors perform surgery within a safe range, and can assist doctors in pursuing personalized surgical plan.
Professor Tu Yihui introduced that robotic assistance can carry out individualized preoperative modeling and planning to ensure accurate and safe intraoperative operations. Minimally invasive provides the possibility to reduce the risk of unsatisfactory prosthesis alignment after surgery, and improve the survival rate of the prosthesis. The treatment of elderly knee arthritis has thus entered the era of robots, and patients are expected to benefit from one operation for life.
（Pan Jiayi）