jktoКафедра травматологии и ортопедииDepartment of Traumatology and Orthopaedics2226-2016ПРОФИЛЬ — 2С10.17238/issn2226-2016.2025.4.39-52jkto-29Research ArticleОРИГИНАЛЬНОЕ ИССЛЕДОВАНИЕORIGINAL RESEARCHВыравнивание оси конечости при роботизированной тотальной артропластике коленаAlignment of the limb axis in robotic total knee arthroplastyhttps://orcid.org/0000-0002-2202-8149ЛычагинА. В.LychaginA. V.

Лычагин Алексей Владимирович – доктор медицинских наук, профессор, заведующий кафедрой травматологии, ортопедии и хирургии катастроф.

Москва, 119991

Alexey V. Lychagin – Doctor of Medical Sciences, Professor, Head of Department of traumatology, orthopedics and disaster surgery, I.M. Sechenov First Moscow State Medical University (Sechenov University).

Moscow, 119991

dr.lychagin@mail.ruhttps://orcid.org/0000-0003-4202-4468ГрицюкА. А.GritsyukA. A.

Грицюк Андрей Анатольевич – доктор мед. наук, профессор кафедры травматологии, ортопедии и хирургии катастроф.

Москва, 119991

Andrey A. Gritsyuk - MD, PhD, Professor of the Department of Traumatology, Orthopedics, and Disaster Surgery at I.M. Sechenov First Moscow State Medical University (Sechenov University).

Moscow, 119991

drgaamma@gmail.comhttps://orcid.org/0000-0002-4811-5718ЕлизаровМ. П.ElizarovM. P.

Елизаров Михаил Павлович – кандидат мед. наук, Заведующий травматолого-ортопедическим отделением, доцент кафедры травматологии, ортопедии и хирургии катастроф.

Москва, 119991

Mikhail P. Elizarov - MD, PhD. Doctor of Medical Sciences, Head of the Traumatology and Orthopedics Department, Associate Professor of the Department of Traumatology, Orthopedics, and Disaster Surgery at I.M. Sechenov First Moscow State Medical University (Sechenov University).

Moscow, 119991

elizarovm07@gmail.comhttps://orcid.org/0009-0001-2342-504XТомбоидиК. Х.TomboidiK. Kh.

Томбоиди Константин Хадисович – аспирант кафедры травматологии, ортопедии и хирургии катастроф.

Москва, 119991

Konstantin Kh. Tomboidi - Postgraduate Student of the Department of Traumatology, Orthopedics, and Disaster Surgery at I.M. Sechenov First Moscow State Medical University (Sechenov University).

Moscow, 119991

tomboidi@mail.ruХалимовМ. М.KhalimovM. M.

Халимов Манучехр Мухсидинович – аспирант кафедры травматологии, ортопедии и хирургии катастроф.

Москва, 119991

Manuchehr M. Khalimov - Postgraduate Student of the Department of Traumatology, Orthopedics, and Disaster Surgery at I.M. Sechenov First Moscow State Medical University (Sechenov University).

Moscow, 119991

manuchehrhalimov1@gmail.comФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Минздрава России (Сеченовский Университет)РоссияFederal State Autonomous Educational Institution of Higher Education First Moscow State Medical University named after I.M. Sechenov Ministry of Health of Russia (Sechenov University)Russian Federation202513032026043952Copyright © Лычагин А.В., Грицюк А.А., Елизаров М.П., Томбоиди К.Х., Халимов М.М., 20262026Лычагин А.В., Грицюк А.А., Елизаров М.П., Томбоиди К.Х., Халимов М.М.Lychagin A.V., Gritsyuk A.A., Elizarov M.P., Tomboidi K.K., Khalimov M.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.jkto.moscow/jour/article/view/29

Традиционные методы выравнивания оси конечности: механическое и анатомическое, кинематическое и функциональное выравнивание (МВ и АВ, КВ и ФВ) – все основаны на уровне и угле резекции бедренной и большеберцовой костей и последующей балансировкой сгибательно-разгибательных и медиально-латеральных межкостных зазоров путем высвобождения (релиза) капсулы и связок коленного сустава, что исправляет фиксированные деформации и приводит конечность в правильное положение. ФВ достигает сбалансированных зазоров сгибания и разгибания и натяжения мягких тканей путем корректировки резекции кости, точной настройки положения компонентов и уменьшения высвобождения мягких тканей с помощью роботизированной системы.

Цель этой статьи – дать сравнительное описание техники различных методик выравнивания оси конечности при тотальном эндопротезировании коленного сустава с использованием автономной роботизированной платформы на основе анализа изображений компьютерной томографии, предоперационного индивидуального планирования и интраоперационного мягкотканного баланса.

Материалы и методы

Материалы и методы: В статье на собственном клиническом материале приведена пошаговая техника выполнения роботизированного тотального эндопротезирования коленного сустава по методикам механического , анатомического, кинематического и функционального выравнивания оси конечностей, описаны принципы и методика планирования, техника хирургического вмешательства.

Результаты

Результаты: В период исследования с октября 2023 г. по ноябрь 2025 г. было проведено роботизированное тотальное эндопротезирование коленного сустава в клинике травматологии, ортопедии и патологии суставов университетской клинической больницы № 1 Сеченовского Университета 472 пациентам.

Вывод

Вывод .Тотальное эндопротезирование коленного сустава может быть безопасно выполнено любым из представленных методов выравнивания оси конечности, однако восстановить естественную анатомию пациента с помощью традиционных инструментов иногда бывает непросто, поэтому применение роботизированных технологий с возможностью интраоперационной визуализации и коррекции положения имплантатов могут быть весьма перспективны, хотя не имеют на сегодняшний день отдаленных преимуществ, что диктует необходимость дальнейших исследований, чтобы выявить ограничения эти методов и определить, кому из пациентов какой вид коррекции оси конечности и позиционирования имплантатов сможет принести существенную пользу.

Traditional methods of limb axis alignment—mechanical and anatomical, kinematic and functional alignment (MA and AA, KA and FA) – are all based on the level and angle of femoral and tibial resection and subsequent balancing of flexion-extension and medial-lateral interosseous gaps by releasing the knee joint capsule and ligaments, which corrects fixed deformities and brings the limb into proper alignment. FA achieves balanced flexion-extension gaps and soft tissue tension by adjusting bone resection, fine-tuning component positions, and reducing soft tissue release using a robotic system.

The purpose of this article is to provide a comparative description of various limb axis alignment techniques for total knee arthroplasty using an autonomous robotic platform based on computed tomography image analysis, preoperative individualized planning, and intraoperative soft tissue balance.

Materials and Methods

Materials and Methods: This article, using our own clinical data, presents a step-by-step technique for performing robotic total knee arthroplasty using mechanical, anatomical, kinematic, and functional limb axis alignment techniques. It also describes the principles and methods of planning and surgical technique.

Results

Results: From October 2023 to November 2025, 472 patients underwent robotic total knee arthroplasty at the Traumatology, Orthopedics, and Joint Pathology Clinic of Sechenov University Clinical Hospital No. 1.

Conclusion

Conclusion: Total knee arthroplasty can be safely performed using any of the presented methods of limb alignment. However, restoring a patient's natural anatomy using traditional instruments can sometimes be challenging. Therefore, the use of robotic technologies with intraoperative visualization and implant positioning may be very promising, although they currently lack long-term benefits. This necessitates further research to identify the limitations of these methods and determine which patients will benefit most from which type of limb alignment and implant positioning.

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The authors declare that there are no conflicts of interest present.