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中华老年骨科与康复电子杂志 ›› 2026, Vol. 12 ›› Issue (02) : 114 -122. doi: 10.3877/cma.j.issn.2096-0263.2026.02.008

综述

机器人辅助全膝关节置换术与单髁关节置换术的研究进展
张轶普1,2, 耿霄1,2, 王鑫光1,2, 董子漾1,2, 郑宇航1,2, 田华1,2,()   
  1. 1100191 北京大学第三医院骨科
    2100191 北京,骨与关节精准医学教育部工程中心
  • 收稿日期:2026-03-03 出版日期:2026-04-05
  • 通信作者: 田华
  • 基金资助:
    北京市自然科学基金昌平重点研究专题(L234012); 北京市自然科学基金昌平创新联合基金重点项目(L254010); 北京市科学技术委员会医药创新品种及平台培育项目(2241100009024023); 北京大学第三医院队列建设项目B类(BYSYDL2023007)

Research progress on Robotic-assisted Total Knee Arthroplasty and Robotic-assisted Unicompartmental Knee Arthroplasty

Yipu Zhang1,2, Xiao Geng1,2, Xinguang Wang1,2, Ziyang Dong1,2, Yuhang Zheng1,2, Hua Tian1,2,()   

  1. 1Department of Orthopaedics, Peking University Third Hospital, Beijing 100191
    2Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing 100191, China
  • Received:2026-03-03 Published:2026-04-05
  • Corresponding author: Hua Tian
引用本文:

张轶普, 耿霄, 王鑫光, 董子漾, 郑宇航, 田华. 机器人辅助全膝关节置换术与单髁关节置换术的研究进展[J/OL]. 中华老年骨科与康复电子杂志, 2026, 12(02): 114-122.

Yipu Zhang, Xiao Geng, Xinguang Wang, Ziyang Dong, Yuhang Zheng, Hua Tian. Research progress on Robotic-assisted Total Knee Arthroplasty and Robotic-assisted Unicompartmental Knee Arthroplasty[J/OL]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2026, 12(02): 114-122.

膝骨关节炎(KOA)是老年人群致残的常见原因之一。随着全球人口老龄化的加剧,KOA患病率持续攀升,这对膝关节置换手术的精准性及临床疗效都提出了更高、更明确的要求。传统全膝关节置换术(TKA)和单髁关节置换术(UKA)是治疗终末期KOA的有效手段,但是二者都存在假体定位偏差、软组织平衡不佳及手术结果高度依赖术者经验等局限性。机器人辅助技术的出现为解决这些问题带来了新的技术途径,机器人辅助全膝关节置换术(RATKA)及机器人辅助单髁关节置换术(RAUKA)以术前精准规划、术中实时导航、机械臂辅助操作等多种方式,实现了手术精度、可重复性及标准化水平的大幅提升。因此,本文系统综述RATKA与RAUKA的技术原理、临床研究进展及疗效评价,并比较两者的核心差异,在此基础上分析当前技术应用面临的挑战,并展望人工智能和个体化假体等前沿技术的融合趋势。

Knee osteoarthritis (KOA) is one of the leading causes of disability in the elderly population. With the global rise in aging populations, the prevalence of KOA continues to climb, placing higher and more specific demands on the precision and clinical efficacy of knee replacement surgery. Traditional total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) are both effective treatments for end-stage KOA. However, both procedures share limitations such as prosthesis positioning errors, suboptimal soft tissue balance, and highly operator-dependent outcomes. The advent of robotic-assisted technology offers a revolutionary new approach to addressing these challenges. Robotic-assisted total knee arthroplasty (RATKA) and robotic-assisted unicompartmental knee arthroplasty (RAUKA) significantly enhance surgical precision, reproducibility, and standardization through preoperative planning, intraoperative real-time navigation, and robotic arm-assisted manipulation. This paper systematically reviews the technical foundations, research progress, clinical efficacy, and core differences between RATKA and RAUKA. It analyzes challenges encountered in current applications and explores integration trends with cutting-edge technologies like artificial intelligence and personalized prostheses, providing reference for clinical practice and future research.

表1 不同系统技术特点及临床应用优势
表2 RATKA与RAUKA特点比较
1
Hunter D J, Bierma-Zeinstra S. Osteoarthritis [J]. Lancet, 2019, 393(10182): 1745-59. CAS.
2
Steinhaus ME, Christ AB, Cross MB. Total knee arthroplasty for knee osteoarthritis: support for a foregone conclusion? [J]. HSS J, 2017, 13(2): 207-210.
3
Chen J, Chen X, Wang T, et al. Global burden of knee osteoarthritis from 1990 to 2021: Trends, inequalities, and projections to 2035[J]. Plos one, 2025, 20(6): e0320115.
4
Steinmetz JD, Culbreth GT, Haile LM, et al. Global, regional, and national burden of osteoarthritis, 1990-2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021 [J]. Lancet Rheumatol, 2023, 5(9): e508-e522.
5
Wang B, Sun H, Fu Z, et al. Application of unicompartmental knee arthroplasty in the treatment of knee osteoarthritis [J]. Arthroplasty, 2021, 3(1): 12.
6
Bourne RB, Chesworth BM, Davis AM, et al. Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? [J]. Clin Orthop Relat Res, 2010, 468(1): 57-63.
7
Park KK, Han CD, Yang IH, et al. Robot-assisted unicompartmental knee arthroplasty can reduce radiologic outliers compared to conventional Techniques [J]. PLoS One, 2019, 14(12): e0225941.
8
Yeung MHY, Fu H, Cheung A, et al. Robotic arm-assisted unicondylar knee arthroplasty resulted in superior radiological accuracy: a propensity score-matched analysis [J]. Arthroplasty, 2023, 5(1): 55.
9
Klincke V, Huyghe R, Vermue H, et al. Robot-assisted total knee arthroplasty demonstrates superior radiological but comparable clinical outcomes compared to conventional techniques: a meta-analysis of prospective studies [J]. Knee Surg Sports Traumatol Arthrosc, 2026, 34(2): 618-632.
10
Kim SE, Han HS. Robotic-assisted unicompartmental knee arthroplasty: historical perspectives and current innovations [J]. Biomed Eng Lett, 2023, 13(4): 543-552.
11
Nam CH, Lee SC, Kim JH, et al. Robot-assisted total knee arthroplasty improves mechanical alignment and accuracy of component positioning compared to the conventional technique [J]. J Exp Orthop, 2022, 9(1): 108.
12
宋涯含,晁洪露,田华,窦豆,赵旻暐.机器人在骨科应用相关研究的国际现状与趋势分析[J/OL].中华老年骨科与康复电子杂志, 2023, 09(01): 59-64.
13
Wada K, Hamada D, Tamaki Y, et al. Robotic-assisted total knee arthroplasty: systematic review of surgical assist robotic systems available in Japan [J]. J Joint Surg Res, 2025, 3(2): 90-95.
14
Roche M. The MAKO robotic-arm knee arthroplasty system [J]. Arch Orthop Trauma Surg, 2021, 141(12): 2043-2047.
15
Neira I, Llopis R, Cuadrado L, et al. Analysis of the initial learning curve for robotic-assisted total knee arthroplasty using the ROSA® knee system [J]. J Clin Med, 2024, 13(11): 3349.
16
Weaver DJ, Deshmukh S, Bashyal R, et al. Complications and learning curve associated with an imageless burr-based (CORI) robotic-assisted total knee arthroplasty system: Results from first 500 cases [J]. Indian J Orthop, 2024, 58(8): 1109-1117.
17
Zhao X, Mi Q, Wang W, et al. Comparative analysis of HURWA versus MAKO robotic-assisted TKA: a prospective cohort study of surgical accuracy and clinical outcomes [J]. J Robot Surg, 2026, 20(1): 175.
18
Ong MTY, He C, Chai W, et al. Surgical accuracy of open platform image-based robotic-assisted total knee arthroplasty across different implants: a multicentre trial [J]. Arthroplasty, 2025, 7(1): 50.
19
Jung WH, Seo M, Sahu V, et al. Evaluating the accuracy of Cuvis™ robot assisted total knee arthroplasty using offset type tensor system in ligament gap balancing [J]. J Clin Orthop Trauma, 2025, 68: 103095.
20
Fu X, She Y, Jin G, et al. Comparison of robotic-assisted total knee arthroplasty: an updated systematic review and meta-analysis [J]. J Robot Surg, 2024, 18(1): 292.
21
Tran JYS, Mak RWF, Ho KKW, et al. Novel application of an imageless robotic system in simultaneous unicompartmental knee arthroplasty and anterior cruciate ligament reconstruction [J]. Asia Pac J Sports Med Arthrosc Rehabil Technol, 2025, 39: 37-40.
22
Kayani B, Konan S, Tahmassebi J, et al. Robotic-arm assisted total knee arthroplasty is associated with improved early functional recovery and reduced time to hospital discharge compared with conventional jig-based total knee arthroplasty: a prospective cohort study [J]. Bone Joint J, 2018, 100(7): 930-937.
23
Pius AK, Sporer SM, Sterling O, et al. Navigated and robotic total knee arthroplasty do not confer improved 5-year survivorship compared to conventional total knee arthroplasty: an analysis from the American Joint Replacement Registry [J]. J Arthroplasty, 2025, 40(7): S130-S139.
24
Albelooshi A, Hamie M, Bollars P, et al. Image-free handheld robotic-assisted technology improved the accuracy of implant positioning compared to conventional instrumentation in patients undergoing simultaneous bilateral total knee arthroplasty, without additional benefits in improvement of clinical outcomes [J]. Knee Surg Sports Traumatol Arthrosc, 2023, 31(11): 4833-4841.
25
Marchand KB, Ehiorobo J, Mathew KK, et al. Learning curve of robotic-assisted total knee arthroplasty for a high-volume surgeon [J]. J Knee Surg, 2022, 35(04): 409-415.
26
Lau WH, Liu WKT, Chiu KY, et al. Reducing edge loading and alignment outliers with image-free robotic-assisted unicompartmental knee arthroplasty: a case controlled study [J]. Arthroplasty, 2024, 6(1): 33.
27
Lei K, Feng Q. Comment on "Robot-Assisted versus Conventional Total and Unicompartmental Knee Arthroplasty: A Meta-analysis of Radiological and Functional Outcomes" [J]. J Knee Surg, 2022, 35(04): 466-468.
28
Luo TD, Braun SB, Lanting BA. What’s New in Adult Reconstructive Knee Surgery [J]. JBJS, 2026, 108(2): 83-91.
29
田华.机器人辅助人工髋膝关节置换手术是必然趋势[J].中华医学杂志, 2022, 102(1): 4-8.
30
乔桦,李慧武.膝关节置换手术机器人应用现状与研究进展[J].山东大学学报(医学版), 2023, 61(3): 29-36.
31
Pearle AD, O'Loughlin PF, Kendoff DO. Robot-assisted unicompartmental knee arthroplasty [J]. J Arthroplasty, 2010, 25(2): 230-237.
32
Kort N, Stirling P, Pilot P, et al. Robot-assisted knee arthroplasty improves component positioning and alignment, but results are inconclusive on whether it improves clinical scores or reduces complications and revisions: a systematic overview of meta-analyses [J]. Knee Surg Sports Traumatol Arthrosc, 2022, 30(8): 2639-2653.
33
Zhang P, Xu K, Zhang J, et al. Comparison of robotic-assisted versus conventional unicompartmental knee arthroplasty for the treatment of single compartment knee osteoarthritis: a meta-analysis [J]. Int J Med Robot, 2021, 17(1): 1-11.
34
南少奎,李铁键,肖龙涛,等.机器人辅助膝关节单髁置换可以获得良好的术后软组织平衡:一项单间室压力传感器研究[J].骨科, 2024, 15(5): 388-393.
35
Kayani B, Konan S, Tahmassebi J, et al. An assessment of early functional rehabilitation and hospital discharge in conventional versus robotic-arm assisted unicompartmental knee arthroplasty: a prospective cohort study [J]. Bone Joint J, 2019, 101(1): 24-33.
36
Clement ND, Bell A, Simpson P, et al. Robotic-assisted unicompartmental knee arthroplasty has a greater early functional outcome when compared to manual total knee arthroplasty for isolated medial compartment arthritis [J]. Bone Joint Res, 2020, 9(1): 15-22.
37
Gaudiani MA, Samuel LT, Diana JN, et al. 5-Year Survivorship and Outcomes of Robotic-Arm-Assisted Medial Unicompartmental Knee Arthroplasty [J]. Appl Bionics Biomech, 2022, 2022(1): 8995358.
38
Bayoumi T, Kleeblad LJ, Borus TA, et al. Ten-year survivorship and patient satisfaction following robotic-arm-assisted medial unicompartmental knee arthroplasty: a prospective multicenter study [J]. JBJS, 2023, 105(12): 933-942.
39
Zambianchi F, Daffara V, Franceschi G, et al. Robotic arm-assisted unicompartmental knee arthroplasty: high survivorship and good patient-related outcomes at a minimum five years of follow-up [J]. Knee Surg Sports Traumatol Arthrosc, 2021, 29(10): 3316-3322.
40
Pearle AD, van der List JP, Lee L, et al. Survivorship and patient satisfaction of robotic-assisted medial unicompartmental knee arthroplasty at a minimum two-year follow-up [J]. Knee, 2017, 24(2): 419-428.
41
Koh CK, Garceau S, Grammatopoulos G, et al. Hip and Knee Arthroplasty in Patients with Obesity [J]. JBJS, 2021: 10.2106.
42
Chen X, Wang B, Huang J, et al. Mid- to long-term complications and revision rates of robotic-assisted unicompartmental knee arthroplasty: a systematic review and meta-analysis [J]. Front Surge, 2025, 12: 1619644.
43
Liu Z, Luo S, Wang C, et al. The current status and future perspectives of robot-assisted joint replacement: A review [J]. Orthop Tissue Engin, 2025: 025300005.
44
Zhang H, Bai X, Wang H, et al. Learning curve analysis of robotic-assisted total knee arthroplasty with a Chinese surgical system [J]. J Orthop Surg Res, 2023, 18(1): 900.
45
Zhang H, Jiang X, Jin B, et al. Current developments in robotic assistance technology for total knee arthroplasty: a comprehensive overview [J]. J Orthop Surg Res, 2025, 20(1): 80.
46
Parkar AP, Adriaensen ME. ESR essentials: MRI of the knee—practice recommendations by ESSR [J]. Europ Radiol, 2024, 34(10): 6590-6599.
47
Jevnikar BE, Khan ST, Emara AK, et al. Robotic total hip and knee arthroplasty: economic impact and workflow efficiency [J]. J Robotic Surg, 2025, 19(1): 578.
48
Cho KJ, Seon JK, Jang WY, et al. Robotic versus conventional primary total knee arthroplasty: clinical and radiological long-term results with a minimum follow-up of ten years [J]. Int Orthop, 2019, 43(6): 1345-1354.
49
何宜蓁,耿霄,田华.机器人辅助髋膝关节置换术的应用现状及趋势分析[J].中华骨与关节外科杂志, 2023, 16(04): 378-384.
50
韩媛媛,张泽,薛庆云,等.智能训练系统在全膝关节置换术患者围术期康复训练中的应用:一项前瞻性随机对照研究[J/OL].中华老年骨科与康复电子杂志, 2025, 11(05): 295-302.
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