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[市场概述:机器人辅助关节置换术:当前的机器人系统、学习曲线和成本分析]

[Market overview: Robotic-assisted arthroplasty : Current robotic systems, learning curve and cost analysis].

作者信息

Tuecking Lars-René, Ettinger Max, Windhagen Henning, Savov Peter

机构信息

Orthopädische Klinik der MHH im Diakovere Annastift, Anna-von-Borries-Str. 1-6, 30625, Hannover, Deutschland.

出版信息

Orthopadie (Heidelb). 2022 Sep;51(9):727-738. doi: 10.1007/s00132-022-04286-x. Epub 2022 Aug 9.

DOI:10.1007/s00132-022-04286-x
PMID:35945459
Abstract

Robotic-assisted arthroplasty has been rapidly entering clinical routine in recent years. The leading endoprosthesis manufacturers have all meanwhile placed robotic systems on the market, which, however, differ significantly from one another technically. Current systems are currently classified according to the degree of autonomy (active vs. semi-active vs. passive) and the data/image source (image-based: CT vs. X‑ray, imageless). Some systems already offer the possibility of robotic-assisted or navigated implantation of hip endoprostheses. In the following review article, the currently leading robotic systems will be presented and compared with regard to their characteristics. Furthermore, the analysis of the learning curves for the different systems, currently available cost analysis models and an outlook on future developments and challenges will be given.

摘要

近年来,机器人辅助关节置换术已迅速进入临床常规应用。与此同时,主要的关节假体制造商均已将机器人系统投放市场,然而,这些系统在技术上彼此差异显著。目前的系统根据自主程度(主动型、半主动型、被动型)和数据/图像来源(基于图像的:CT 与 X 光、无图像)进行分类。一些系统已经提供了机器人辅助或导航植入髋关节假体的可能性。在接下来的综述文章中,将介绍当前领先的机器人系统,并对其特点进行比较。此外,还将给出不同系统学习曲线的分析、当前可用的成本分析模型以及对未来发展和挑战的展望。

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Orthopadie (Heidelb). 2022 Sep;51(9):727-738. doi: 10.1007/s00132-022-04286-x. Epub 2022 Aug 9.
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本文引用的文献

1
Albumin is an Independent Predictor of up to 9-Year Mortality for Intracapsular Femoral Neck Fractures Aiding in Decision-Making for Total Hip Arthroplasty or Hemiarthroplasty.白蛋白是囊内股骨颈骨折长达9年死亡率的独立预测指标,有助于全髋关节置换术或半髋关节置换术的决策制定。
J Arthroplasty. 2023 Jan;38(1):135-140. doi: 10.1016/j.arth.2022.08.015. Epub 2022 Aug 11.
2
Preoperative Statin Exposure Reduces Periprosthetic Fractures and Revisions following Total Knee Arthroplasty.术前他汀类药物暴露可降低全膝关节置换术后的假体周围骨折和翻修率。
J Knee Surg. 2023 Oct;36(12):1259-1265. doi: 10.1055/s-0042-1755359. Epub 2022 Aug 9.
3
Robotic-assisted total knee arthroplasty: Is there a maximum level of efficiency for the operating surgeon?
机器人辅助全膝关节置换术:手术医生的效率是否存在最高水平?
J Orthop. 2022 Feb 15;31:13-16. doi: 10.1016/j.jor.2022.02.015. eCollection 2022 May-Jun.
4
Comparative Cost Analysis of Four Different Computer-Assisted Technologies to Implant a Total Knee Arthroplasty over Conventional Instrumentation.四种不同计算机辅助技术与传统器械植入全膝关节置换术的成本比较分析
J Pers Med. 2022 Jan 30;12(2):184. doi: 10.3390/jpm12020184.
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Learning Curve of Robotic-Assisted Total Knee Arthroplasty for Non-Fellowship-Trained Orthopedic Surgeons.非专科培训骨科医生的机器人辅助全膝关节置换术学习曲线
Arthroplast Today. 2022 Jan 22;13:194-198. doi: 10.1016/j.artd.2021.10.020. eCollection 2022 Feb.
6
The Cost-Effectiveness of Robotic-Assisted Versus Manual Total Knee Arthroplasty: A Markov Model-Based Evaluation.机器人辅助与手动全膝关节置换术的成本效益比较:基于马尔可夫模型的评估。
J Am Acad Orthop Surg. 2022 Feb 15;30(4):168-176. doi: 10.5435/JAAOS-D-21-00309.
7
High accuracy of a new robotically assisted technique for total knee arthroplasty: an in vivo study.新型机器人辅助全膝关节置换术具有高精度:一项体内研究。
Knee Surg Sports Traumatol Arthrosc. 2023 Mar;31(3):1153-1161. doi: 10.1007/s00167-021-06800-8. Epub 2022 Jan 4.
8
Image-Free Robotic-Assisted Total Knee Arthroplasty Improves Implant Alignment Accuracy: A Cadaveric Study.无影像机器人辅助全膝关节置换术提高植入物对线准确性:一项尸体研究。
J Arthroplasty. 2022 Apr;37(4):795-801. doi: 10.1016/j.arth.2021.12.035. Epub 2022 Jan 1.
9
Robotic Versus Manual Total Knee Arthroplasty in High Volume Surgeons: A Comparison of Cost and Quality Metrics.机器人辅助与手动全膝关节置换术在高量手术医生中的比较:成本和质量指标的比较。
J Arthroplasty. 2022 Aug;37(8S):S782-S789. doi: 10.1016/j.arth.2021.12.018. Epub 2021 Dec 21.
10
The initial learning curve for the ROSA® Knee System can be achieved in 6-11 cases for operative time and has similar 90-day complication rates with improved implant alignment compared to manual instrumentation in total knee arthroplasty.ROSA®膝关节系统的初始学习曲线在手术时间方面可通过6至11例手术达成,与全膝关节置换术中的手动器械相比,其90天并发症发生率相似,但植入物对线得到了改善。
J Exp Orthop. 2021 Dec 20;8(1):119. doi: 10.1186/s40634-021-00438-8.