医疗机器人的出现已经改变了手术的发展，相对于传统手术，使用手术机器人在提升精准度、减少工作强度等方面有着巨大的帮助。然而由于资源的短缺，全自动全流程的手术机器人将成为元宇宙医学的发展趋势。目前的膝关节手术机器人多为半主动模式，即作为助手身份协助医生操作，少数“全自动”机器人也只能满足术中操作的全自动性。本文提出一种基于数字孪生与混合现实的智能膝关节置换术，采取人预演监督、机器规划、操刀的模式，从“半主动”走向“半自动”（全流程）， 可作为向全流程全自动模式发展的一个过渡，在保障安全、易于让医患接受的前提下实现手术的高质量完成，更符合现有技术基础和现实要求，也为元宇宙医学中手术定量评估等方面的发展提供了可能。

The advent of medical robots has transformed the landscape of surgery. Compared to traditional surgical methods, the use of surgical robots provides significant advantages in enhancing precision and reducing the workload for surgeons. However, due to resource constraints, fully automated, end-to-end surgical robots are poised to become a key trend in the development of metaverse medicine. Existing knee surgery robots predominantly operate in a semi-active mode, serving as assistants to surgeons, while a limited number of "fully automated" robots can only achieve full automation during the intraoperative phase. This paper proposes an intelligent knee replacement surgery approach based on digital twin and mixed reality technologies, adopting a model of human pre-operative rehearsal and supervision, machine planning, and robotic execution. This shifts the paradigm from "semi-active" to "semi-automated" (covering the full process), serving as a transitional step toward fully automated end-to-end surgery. By ensuring safety and gaining acceptance from both medical professionals and patients, this approach enables high-quality surgical outcomes. It aligns better with current technological foundations and practical requirements while also offering potential for advancements in quantitative surgical assessment within the realm of metaverse medicine.