Lonner Jess H, Smith Julie R, Picard Frederic, Hamlin Brian, Rowe Philip J, Riches Philip E
Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, 925 Chestnut Street, Philadelphia, PA, 19107, USA,
Clin Orthop Relat Res. 2015 Jan;473(1):206-12. doi: 10.1007/s11999-014-3764-x.
Surgical robotics has been shown to improve the accuracy of bone preparation and soft tissue balance in unicondylar knee arthroplasty (UKA). However, although extensive data have emerged with regard to a CT scan-based haptically constrained robotic arm, little is known about the accuracy of a newer alternative, an imageless robotic system.
QUESTIONS/PURPOSES: We assessed the accuracy of a novel imageless semiautonomous freehand robotic sculpting system in performing bone resection and preparation in UKA using cadaveric specimens.
In this controlled study, we compared the planned and final implant placement in 25 cadaveric specimens undergoing UKA using the new tool. A quantitative analysis was performed to determine the translational, angular, and rotational differences between the planned and achieved positions of the implants.
The femoral implant rotational mean error was 1.04° to 1.88° and mean translational error was 0.72 to 1.29 mm across the three planes. The tibial implant rotational mean error was 1.48° to 1.98° and the mean translational error was 0.79 to 1.27 mm across the three planes.
The image-free robotic sculpting tool achieved accurate implementation of the surgical plan with small errors in implant placement. The next step will be to determine whether accurate implant placement translates into a clinical and functional benefit for the patient.
手术机器人已被证明可提高单髁膝关节置换术(UKA)中骨准备和软组织平衡的准确性。然而,尽管关于基于CT扫描的触觉受限机器人手臂已有大量数据,但对于一种更新的替代方案——无图像机器人系统的准确性却知之甚少。
问题/目的:我们使用尸体标本评估了一种新型无图像半自主徒手机器人雕刻系统在UKA中进行骨切除和准备的准确性。
在这项对照研究中,我们比较了使用新工具对25个接受UKA的尸体标本进行计划植入和最终植入的情况。进行了定量分析,以确定植入物计划位置和实际位置之间的平移、角度和旋转差异。
在三个平面上,股骨植入物的平均旋转误差为1.04°至1.88°,平均平移误差为0.72至1.29毫米。胫骨植入物在三个平面上的平均旋转误差为1.48°至1.98°,平均平移误差为0.79至1.27毫米。
无图像机器人雕刻工具实现了手术计划的精确实施,植入物放置误差较小。下一步将是确定精确的植入物放置是否能为患者带来临床和功能上的益处。