Golden Jubilee National Hospital, Agamemnon Street, Clydebank, G81 4DY, UK; Department of Biomedical Engineering, University of Strathclyde, Wolfson Centre, 106 Rottenrow, Glasgow, G4 0NW, UK.
Golden Jubilee National Hospital, Agamemnon Street, Clydebank, G81 4DY, UK.
Med Eng Phys. 2019 Oct;72:55-65. doi: 10.1016/j.medengphy.2019.08.005.
Computer technology is ubiquitous and relied upon in virtually all professional activities including neurosurgery, which is why it is surprising that it is not the case for orthopaedic surgery with fewer than 5% of surgeons using available computer technology in their procedures. In this review, we explore the evolution and background of Computer Assisted Orthopaedic Surgery (CAOS), delving into the basic principles behind the technology and the changes in the discussion on the subject throughout the years and the impact these discussions had on the field. We found evidence that industry had an important role in driving the discussion at least in knee arthroplasty-a leading field of CAOS-with the ratio between patents and publications increased from approximately 1:10 in 2004 to almost 1:3 in 2014. The adoption of CAOS is largely restrained by economics and ergonomics with sceptics challenging the accuracy and precision of navigation during the early years of CAOS moving to patient functional improvements and long term survivorship. Nevertheless, the future of CAOS remains positive with the prospect of new technologies such as improvements in image-guided surgery, enhanced navigation systems, robotics and artificial intelligence.
计算机技术无处不在，几乎所有专业活动都依赖于它，包括神经外科，这令人惊讶的是，在骨科手术中并非如此，只有不到 5%的外科医生在手术中使用现有的计算机技术。在这篇综述中，我们探讨了计算机辅助骨科手术（CAOS）的发展和背景，深入研究了该技术背后的基本原理，以及多年来关于该主题的讨论的变化，以及这些讨论对该领域的影响。我们发现有证据表明，工业界在推动讨论方面发挥了重要作用，至少在膝关节置换术这一 CAOS 的领先领域是如此，专利与出版物的比例从 2004 年的大约 1:10 增加到 2014 年的近 1:3。CAOS 的采用在很大程度上受到经济和人体工程学的限制，怀疑者质疑 CAOS 早期导航的准确性和精度，转而关注患者的功能改善和长期存活率。然而，CAOS 的未来仍然是积极的，有望出现新的技术，如改进的图像引导手术、增强的导航系统、机器人和人工智能。
