Department of Bone and Joint Surgery, The Second Affiliated Hospital of Xian Jiaotong University, Xi'an, Shaanxi, China.
Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China.
BMC Surg. 2024 Nov 29;24(1):380. doi: 10.1186/s12893-024-02663-1.
The majority of robot-assisted total joint arthroplasties necessitate preoperative computed tomography (CT) scans. Incidental findings in these CT scans can introduce complexity into clinical treatment decisions. Consequently, this study sought to document the nature and frequency of incidental findings identified in preoperative CT imaging conducted for robot-assisted total joint arthroplasty, along with their impact on planned surgical procedures.
This investigation constitutes a retrospective review encompassing patients who underwent primary robot-assisted total hip arthroplasty between January 2020 and January 2022 at the Second Affiliated Hospital of Xi'an Jiaotong University, the First Affiliated Hospital of Peking University, and Nanfang Hospital. It also includes patients who underwent robot-assisted total knee arthroplasty during the same period at the Second Affiliated Hospital of Xi'an Jiaotong University, the Third Affiliated Hospital of Peking University, Nanfang Hospital, and the Second Affiliated Hospital of Zhejiang University. All CT examinations were initially interpreted by proficient musculoskeletal radiologists. Subsequently, the findings in the examination reports, whether significant or non-significant, were compiled and categorized.
A total of 218 patients, median age 63, were evaluated; 90 had incidental findings (41.3%), with 56 (25.7%) significant. Males were more likely to have findings (P = 0.001). Nine needed additional imaging, and five required intervention.Our study highlights the impact of unexpected CT findings on surgical planning, which can delay or cancel surgeries and affect patient outcomes. It also urges surgeons to review medical histories and perform thorough examinations before surgery to prevent serious consequences.
Radiologists often find incidental findings in preoperative CT scans for robot-assisted joint arthroplasty, with a 41.3% incidence rate. About 25.7% of these findings need physician follow-up, and under 5% require intervention, potentially causing delays or cancellations of procedures, while undetected findings could lead to fatal outcomes.Unexpected preoperative CT findings can enhance patient management and prevent complications, necessitating their inclusion in surgical protocols. Systematic assessment improves safety and outcomes, urging surgeons to review medical history and perform thorough examinations pre-surgery.
Clinical trial registration time: 19/05/2022, clinical trial registration number: ChiCTR2200060115.
大多数机器人辅助全关节置换术需要术前计算机断层扫描（CT）检查。这些 CT 扫描中的偶然发现会给临床治疗决策带来复杂性。因此，本研究旨在记录机器人辅助全关节置换术前 CT 成像中发现的偶然发现的性质和频率，以及它们对计划手术的影响。
这是一项回顾性研究，包括 2020 年 1 月至 2022 年 1 月期间在西安交通大学第二附属医院、北京大学第一附属医院和南方医院接受初次机器人辅助全髋关节置换术的患者，以及同期在西安交通大学第二附属医院、北京大学第三附属医院、南方医院和浙江大学第二附属医院接受机器人辅助全膝关节置换术的患者。所有 CT 检查均由熟练的肌肉骨骼放射科医生进行初步解读。随后，将检查报告中的发现（无论是否显著）进行编译和分类。
共评估了 218 例患者，中位年龄为 63 岁；90 例有偶然发现（41.3%），其中 56 例（25.7%）有显著发现。男性更有可能有发现（P = 0.001）。有 9 例需要额外的影像学检查，5 例需要介入治疗。我们的研究强调了意外 CT 发现对手术计划的影响，这可能会导致手术延迟或取消，并影响患者的结局。它还敦促外科医生在手术前审查病史并进行彻底检查，以防止严重后果。
放射科医生经常在机器人辅助关节置换术的术前 CT 扫描中发现偶然发现，发生率为 41.3%。其中约 25.7%的发现需要医生随访，不到 5%需要介入治疗，可能导致手术延迟或取消，而未发现的发现可能导致致命后果。术前意外 CT 发现可以增强患者管理并预防并发症，因此需要将其纳入手术方案中。系统评估可提高安全性和结果，敦促外科医生在手术前审查病史并进行彻底检查。
临床试验注册时间：2022 年 5 月 19 日，临床试验注册号：ChiCTR2200060115。
