Kouyoumdjian Pascal, Mansour Jad, Assi Chahine, Caton Jacques, Lustig Sebastien, Coulomb Remy
Centre Hospitalo-universitaire de Nîmes, Rue du Pr. Robert Debré, 30029 Nîmes, France - Université Montpellier 1, 2 Rue de l'École de Médecine, 34090 Montpellier, France - Laboratoire de Mécanique et Génie Civile (LMGC), CNRS-UM1, 860 Rue de St-Priest, 34090 Montpellier, France.
Department of Orthopedic Surgery, Lebanese American University-Rizk Hospital, Beirut, Lebanon.
SICOT J. 2020;6:45. doi: 10.1051/sicotj/2020041. Epub 2020 Nov 27.
Total hip replacement provides mostly fair functional and clinical results. Many factors play an essential role in hip stability and long-term outcomes. Surgical positioning remains fundamental for obtaining accurate implant fit and prevent hip dislocation or impingement. Different categories of robotic assistance have been established throughout the previous years and all of the technologies target accuracy and reliability to reduce complications, and enhance clinical outcomes.
An overview is proposed over the principles of robotic assistance in hip arthroplasty surgery. Accuracy, reliability, management of the bone stock, clinical outcomes, constraints and limits of this technology are reported, based on recent literature.
Potential advantages regarding pre-operative planning accuracy, cup positioning, maintenance of the center of rotation, preservation of an adequate bone stock nay clinical short- and mid-term outcomes are balanced with some reported disadvantages and limits like hip anatomical specificity, cost-effectiveness, engineering dependence.
The use of robotic-assisted THA presents clear and evident benefits related to accurate implant positioning and maintenance of a minimal bone while allowing. For some authors, an early improvement in functional results and patient's recovery. This technology demonstrated a shorter surgical time and a short learning curve required to optimize its use and this technology presents promising outcomes and results and potential use in routine clinical application but its limitation of use is still present especially the cost of the robot, the need for the presence of an engineer during the surgery, its availability of use in all hospitals as well as the difficulty presented in dysplastic or dysmorphic hip joints.
全髋关节置换术大多能带来尚可的功能和临床效果。许多因素对髋关节稳定性和长期疗效起着至关重要的作用。手术定位对于获得精确的植入物适配以及预防髋关节脱位或撞击仍然至关重要。在过去几年中已确立了不同类别的机器人辅助技术,所有这些技术都旨在提高准确性和可靠性,以减少并发症并改善临床效果。
本文对髋关节置换手术中机器人辅助的原理进行了概述。基于近期文献,报告了该技术的准确性、可靠性、骨量管理、临床效果、限制和局限。
在术前规划准确性、髋臼定位、旋转中心维持、保留足够骨量以及临床短期和中期效果方面的潜在优势,与一些已报道的劣势和局限相权衡,如髋关节解剖特异性、成本效益、对工程技术的依赖等。
使用机器人辅助全髋关节置换术在精确植入物定位和保留最小骨量方面具有明显益处,同时对一些作者而言,能使功能结果和患者恢复得到早期改善。该技术显示出手术时间更短,优化使用所需的学习曲线较短,并且在常规临床应用中呈现出有前景的结果和潜在用途,但其使用仍存在局限性,尤其是机器人的成本、手术期间需要工程师在场、在所有医院的可及性以及发育不良或畸形髋关节所带来的困难。