Department of Orthopedics, Lokmanya Hospital, Nigdi, Pradhikaran, Pune, India.
J Robot Surg. 2022 Apr;16(2):361-367. doi: 10.1007/s11701-021-01249-w. Epub 2021 May 4.
In recent years, robotic technology is becoming more pervasive in joint arthroplasty. The role of robotics in joint replacement surgery is to bring precision and accuracy in bone preparation, implant positioning and soft tissue balancing. However, there is yet to be a study conducted to determine the accuracy of bone preparation done by a new robotic system. The purpose of this study is to evaluate and report on the accuracy of bone cuts using imageless semiautonomous freehand robotic sculpting system, Navio (Smith & Nephew) based on the data provided by the robotic system. Between August 2018 and May 2019, a total of 62 patients were prospectively enrolled in this study. All surgeries were done by the senior author using a medial para-patellar approach and using a posterior stabilised implant (Anthem, Smith & Nephew Inc.). The study included 37 female patients and 25 male patients. The parameters assessed in this study were: (1) mechanical axis, (2) femoral coronal alignment, (3) femoral rotation, (4) femoral sagittal alignment, (5) tibial slope and (6) tibial coronal alignment using paired t test and root mean squared error (RMSE). The robotic system was accurate in achieving the bone cuts as planned in mechanical axis alignment (p = 0.89, RMSE = 0.56), femoral coronal alignment (p = 0.36, RMSE = 0.36), femoral sagittal alignment (p = 0.10, RMSE = 0.44), femoral rotation (p = 0.91, RMSE = 0.11), tibial coronal alignment (p = 0.81, RMSE = 0.24) and tibial slope (p = 0.30, RMSE = 0.37) with the maximum RMSE being 0.56. This study demonstrated that semi-autonomous hand-held robotic system, Navio (Smith & Nephew) for total knee arthroplasty produced accurate component positioning as per plan in all planes. The maximum RMSE was 0.56°.
近年来，机器人技术在关节置换术中的应用越来越广泛。机器人在关节置换手术中的作用是在骨准备、植入物定位和软组织平衡方面实现精确和准确。然而，目前还没有研究来确定新的机器人系统进行的骨准备的准确性。本研究的目的是评估和报告基于机器人系统提供的数据，使用无图像半自动徒手机器人雕刻系统 Navio（Smith & Nephew）进行骨切割的准确性。在 2018 年 8 月至 2019 年 5 月期间，共有 62 名患者前瞻性入组本研究。所有手术均由资深作者使用内侧髌旁入路和后稳定植入物（Anthem，Smith & Nephew Inc.）进行。该研究包括 37 名女性患者和 25 名男性患者。本研究评估的参数包括：（1）机械轴，（2）股骨冠状位对线，（3）股骨旋转，（4）股骨矢状位对线，（5）胫骨倾斜度和（6）胫骨冠状位对线，使用配对 t 检验和均方根误差（RMSE）进行评估。机器人系统在实现机械轴对线（p=0.89，RMSE=0.56）、股骨冠状位对线（p=0.36，RMSE=0.36）、股骨矢状位对线（p=0.10，RMSE=0.44）、股骨旋转（p=0.91，RMSE=0.11）、胫骨冠状位对线（p=0.81，RMSE=0.24）和胫骨倾斜度（p=0.30，RMSE=0.37）方面的骨切割与计划相符，最大 RMSE 为 0.56。本研究表明，用于全膝关节置换的半自动手持机器人系统 Navio（Smith & Nephew）在所有平面上均能按照计划实现准确的组件定位。最大 RMSE 为 0.56°。
