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全膝关节置换术中使用机器人进行计划与实际截骨的相关性:500例患者的前瞻性研究

Correlation Between Planned and Executed Bone Cuts Using Robotics in Total Knee Arthroplasty: A Prospective Study of 500 Patients.

作者信息

Adkar Neeraj, Patil Mangesh, Vaidya Swapnil, Kumbar Rajendra, Kerhalkar Ravi, Mote Girish, Thareja Satwik, Sadalagi Prajwal, Bajwa Supreet

机构信息

Department of Orthopedics, SaiShree Hospital, Sr. No. 157, CTS No. 1104/3, Plot No 26, DP Road, Aundh, Pune, Maharashtra 411007 India.

Department of Orthopedics and Joint Replacement, Wockhardt Hospital, Mumbai Central, Maharashtra India.

出版信息

Indian J Orthop. 2024 Jun 7;58(8):1103-1108. doi: 10.1007/s43465-024-01196-2. eCollection 2024 Aug.

Abstract

OBJECTIVE

This study evaluated the precision of robotic-arm-assisted total knee arthroplasty (RATKA) in performing bone resection, predicting component size, managing soft tissue tension, and determining postoperative range of motion (ROM).

METHODS

A total of 500 participants were enrolled in this prospective cohort research. The procedures were conducted at a single facility, with a uniform method and implant design. The Cuvis system, a fully automated robot, was utilized for the study. The precise removal of bone at both the tibial and femur sites, the positioning of the implant, and the release of soft tissue were documented and then compared to the preoperative plan.

RESULTS

The distal (medial and lateral) femoral cuts had a mean absolute deviation from the plan of 0.23 mm, while the posterior (medial and lateral) femoral cuts had a mean absolute difference of 1 mm and 1.4 mm, respectively. The absolute discrepancies in the medial and lateral tibial cuts are 0.93 mm and - 0.06 mm, respectively. Out of 1000 bone resections, 980 (98%) were within < 1 mm from the preoperative plan. The predictions for the sizes of the tibial and femoral components had accuracies of 100% and 98.9%, respectively.

CONCLUSION

These findings collectively underscore the effectiveness of the fully automated Cuvis robotic system in achieving consistent and accurate results in bone resections and implant sizing, highlighting its potential as a valuable tool in orthopedic surgery.

摘要

目的

本研究评估了机器人手臂辅助全膝关节置换术(RATKA)在进行骨切除、预测假体尺寸、控制软组织张力以及确定术后活动范围(ROM)方面的精度。

方法

共有500名参与者纳入了这项前瞻性队列研究。手术在单一机构进行,采用统一方法和植入物设计。使用Cuvis全自动化机器人系统进行研究。记录了胫骨和股骨部位的精确骨切除、植入物定位以及软组织松解情况,然后与术前计划进行比较。

结果

股骨远端(内侧和外侧)截骨与计划的平均绝对偏差为0.23毫米,而股骨后侧(内侧和外侧)截骨的平均绝对差异分别为1毫米和1.4毫米。胫骨内侧和外侧截骨的绝对差异分别为0.93毫米和 -0.06毫米。在1000次骨切除中,980次(98%)与术前计划的偏差在<1毫米范围内。胫骨和股骨假体尺寸的预测准确率分别为100%和98.9%。

结论

这些发现共同强调了全自动化Cuvis机器人系统在骨切除和假体尺寸确定方面取得一致且准确结果的有效性,突出了其作为骨科手术中有价值工具的潜力。

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Complications and downsides of the robotic total knee arthroplasty: a systematic review.机器人全膝关节置换术的并发症和缺点:系统评价。
Knee Surg Sports Traumatol Arthrosc. 2023 Mar;31(3):736-750. doi: 10.1007/s00167-022-07031-1. Epub 2022 Jun 18.

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