Cosendey Killian, Stanovici Julien, Mahlouly Jaad, Omoumi Patrick, Jolles Brigitte M, Favre Julien
Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), CH-1011 Lausanne, Switzerland.
Service of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), CH-1011 Lausanne, Switzerland.
J Clin Med. 2021 Aug 20;10(16):3714. doi: 10.3390/jcm10163714.
This study aimed to assess the bone cuts accuracy of a system for total knee arthroplasty including an active robotic arm. A second objective was to compare the accuracy among orthopaedic surgeons of different levels of experience.
Three orthopaedic surgeons cut 10 sawbone knees each. Planned and actual bone cuts were compared using computed tomography. Difference with respect to the planning was expressed as three position and three orientation errors following the anatomical planes. Statistical tests were performed to detect bias and compare surgeons.
None of the 30 knees presented an outlier error, meaning an error ≥3 mm or ≥3°. The root-mean-square values of the 12 error types were below 0.8 mm or 0.8°, except for the femoral proximal-distal errors (1.7 mm) and the tibial anterior-posterior errors (1.4 mm). Biases were observed, particularly in femoral proximal-distal and tibial anterior-posterior positions. Median differences between surgeons were all lower than 0.8 mm and 0.5°, with statistically significant differences among surgeons in the femoral proximal-distal errors and the tibial anterior-posterior errors.
The system tested in this study achieved accurate bone cuts independently of the surgeon's level of experience. Biases were observed, suggesting that there might be options to improve the accuracy, particularly in proximal-distal position for the femur and in anterior-posterior position for the tibia.
本研究旨在评估一种包括主动机器人手臂的全膝关节置换系统的截骨准确性。第二个目标是比较不同经验水平的骨科医生之间的准确性。
三名骨科医生每人对10个锯骨膝关节进行截骨。使用计算机断层扫描比较计划截骨和实际截骨。相对于计划的差异表示为沿解剖平面的三个位置误差和三个方向误差。进行统计检验以检测偏差并比较医生。
30个膝关节中没有一个出现异常误差，即误差≥3毫米或≥3°。除股骨近端-远端误差（1.7毫米）和胫骨前后误差（1.4毫米）外，12种误差类型的均方根值均低于0.8毫米或0.8°。观察到偏差，特别是在股骨近端-远端和胫骨前后位置。医生之间的中位数差异均低于0.8毫米和0.5°，在股骨近端-远端误差和胫骨前后误差方面医生之间存在统计学显著差异。
本研究中测试的系统实现了准确的截骨，与医生的经验水平无关。观察到偏差，这表明可能有提高准确性的方法，特别是在股骨的近端-远端位置和胫骨的前后位置。
