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单髁膝关节置换术:机器人技术比传统技术更精确吗?

Unicompartmental knee arthroplasty: is robotic technology more accurate than conventional technique?

作者信息

Citak Mustafa, Suero Eduardo M, Citak Musa, Dunbar Nicholas J, Branch Sharon H, Conditt Michael A, Banks Scott A, Pearle Andrew D

机构信息

Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.

出版信息

Knee. 2013 Aug;20(4):268-71. doi: 10.1016/j.knee.2012.11.001. Epub 2012 Nov 30.

Abstract

BACKGROUND

Robotic-assisted unicompartmental knee arthroplasty (UKA) with rigid bone fixation "can significantly improve implant placement and leg alignment. The aim of this cadaveric study was to determine whether the use of robotic systems with dynamic bone tracking would provide more accurate UKA implant positioning compared to the conventional manual technique.

METHODS

Three-dimensional CT-based preoperative plans were created to determine the desired position and orientation for the tibial and femoral components. For each pair of cadaver knees, UKA was performed using traditional instrumentation on the left side and using a haptic robotic system on the right side. Postoperative CT scans were obtained and 3D-to-3D iterative closest point registration was performed. Implant position and orientation were compared to the preoperative plan.

RESULTS

Surgical RMS errors for femoral component placement were within 1.9 mm and 3.7° in all directions of the planned implant position for the robotic group, while RMS errors for the manual group were within 5.4mm and 10.2°. Average RMS errors for tibial component placement were within 1.4mm and 5.0° in all directions for the robotic group; while, for the manual group, RMS errors were within 5.7 mm and 19.2°.

CONCLUSIONS

UKA was more precise using a semiactive robotic system with dynamic bone tracking technology compared to the manual technique.

摘要

背景

采用刚性骨固定的机器人辅助单髁膝关节置换术(UKA)“可显著改善植入物放置和下肢对线。本尸体研究的目的是确定与传统手动技术相比,使用具有动态骨跟踪功能的机器人系统是否能提供更精确的UKA植入物定位。

方法

创建基于三维CT的术前计划,以确定胫骨和股骨组件的理想位置和方向。对于每对尸体膝关节,左侧使用传统器械进行UKA,右侧使用触觉机器人系统进行UKA。术后进行CT扫描,并进行三维到三维的迭代最近点配准。将植入物的位置和方向与术前计划进行比较。

结果

机器人组股骨组件放置的手术均方根误差在计划植入位置的所有方向上均在1.9毫米和3.7°以内,而手动组的均方根误差在5.4毫米和10.2°以内。机器人组胫骨组件放置的平均均方根误差在所有方向上均在1.4毫米和5.0°以内;而手动组的均方根误差在5.7毫米和19.2°以内。

结论

与手动技术相比,使用具有动态骨跟踪技术的半主动机器人系统进行UKA更为精确。

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