Выравнивание оси конечости при роботизированной тотальной артропластике колена

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: 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: 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 .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.

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