Chai Wei, Xie Jie, Zhang Xiaogang, He Chuan, Yan Tingfang, Liu Li, Zhang Yuan, Zhou Zongke, Hu Yihe, Cao Li, Chen Jiying, Tang Peifu
Department of Orthopedics, the First Medical Center of Chinese PLA General Hospital, Beijing, 100853, P.R.China.
Department of Orthopedics, Xiangya Hospital Central South University, Changsha Hunan, 410008, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021 Apr 15;35(4):409-413. doi: 10.7507/1002-1892.202010021.
To simulate and validate the performance, accuracy, and safety of the Yuanhua robotic-assisted total knee arthroplasty system (YUANHUA-TKA) through cadaver-based experiment, thus optimizing the robotic system for the future human clinical application.
Six unilateral adult cadaver specimens of the lower limbs were scanned by three-dimensional CT before the experiment, and then the three-dimensional models of femur and tibia were obtained by using the preoperative software of YUANHUA-TKA system, so as to plan the type of prosthesis implant, the osteotomy volume and osteotomy angles [hip-knee-ankle angle (HKA), coronal frontal femoral component (FFC) and frontal tibial component (FTC)], the ideal value of HKA was set to 180°, and of FFC and FTC were set to 90°, respectively. The operator could further confirm the osteotomy plan according to the intraoperative situation before osteotomy, and then install the prosthesis after completing the osteotomy in each plane with the assistance of YUANHUA-TKA system. At last, the X-ray films of hip joint, knee joint, and ankle joint were taken and stitched into the full length X-ray film of the lower limb, and HKA, coronal FFC and FTC were measured.
During the experiment, YUANHUA-TKA system ran stably. All sections of femur and tibia were smooth and no ligament injury was found. After operation, the HKA was 177.1°-179.7°, FFC was 87.9°-91.4°, and FTC was 87.3°-91.4°, which were within ±3° from the ideal values of preoperative planning.
The YUANHUA-TKA system can assist the surgeon to carry out precise osteotomy according to the preoperative planned value, which has a good auxiliary effect for total knee arthroplasty. It is expected to assist joint surgeons to improve the surgical accuracy in clinical application.
通过基于尸体的实验模拟并验证源华机器人辅助全膝关节置换系统(YUANHUA-TKA)的性能、准确性和安全性,从而为未来的人体临床应用优化该机器人系统。
实验前对6例单侧成人下肢尸体标本进行三维CT扫描,然后利用YUANHUA-TKA系统的术前软件获取股骨和胫骨的三维模型,以规划假体植入类型、截骨量和截骨角度[髋-膝-踝角(HKA)、冠状面股骨组件(FFC)和胫骨组件(FTC)],HKA的理想值设定为180°,FFC和FTC的理想值分别设定为90°。手术者可在截骨前根据术中情况进一步确认截骨方案,然后在YUANHUA-TKA系统的辅助下完成各平面截骨后安装假体。最后,拍摄髋关节、膝关节和踝关节的X线片并拼接成下肢全长X线片,测量HKA、冠状面FFC和FTC。
实验过程中,YUANHUA-TKA系统运行稳定。股骨和胫骨的所有截面均光滑,未发现韧带损伤。术后,HKA为177.1°-179.7°,FFC为87.9°-91.4°,FTC为87.3°-91.4°,与术前规划的理想值相差±3°以内。
YUANHUA-TKA系统可辅助外科医生按照术前规划值进行精确截骨,对全膝关节置换术有良好的辅助作用。有望在临床应用中辅助关节外科医生提高手术精度。