Robot-assisted technique can achieve accurate screw placement in four-corner fusion and reduce operative difficulty: a cadaver study.

IF 2.8 3区 医学 Q1 ORTHOPEDICS
Zhixin Wang, Bo Liu, Zhe Yi, Ke Xu, Shijie Jia, Qianqian Wang, Yaobin Yin
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Abstract

Background: The purpose of this study is to explore the feasibility and accuracy of a robot-assisted technique in four-corner fusion compared with traditional freehand operation.

Methods: Twenty cadaver specimens were randomly assigned to the robot-assisted group and freehand groups. Three screws were placed percutaneously to fix the capitate-lunate joint, lunate-triquetrum joint, and triquetrum-hamate-capitate joint in each specimen by robot-assisted or freehand technique. The offset between the actual and planned screw positions was determined by merging the images of intraoperative and postoperative CT scans in the robot-assisted group. The centrality of the screw, time-consuming, drilling attempts, and radiation exposure were compared between the two groups.

Results: The mean offset between the actual and planned screw position was 1.09 (SD: 0.56) mm. The offset at the start point of the screw was significantly lower than that at the endpoint. There was no significant difference in the centrality of the screws, surgical time between the two groups. The number of drilling attempts and the radiation dose received by surgeons were significantly lower in the robot-assisted group.

Conclusions: Although there was no significant difference in screw centrality between the two groups, the slight offset between the actual and planned screw positions confirmed the feasibility of the robot-assisted technique in four-corner fusion. The robot-assisted technique has advantages in reducing the difficulty of surgery and protecting the surgeon from exposure to large doses of radiation.

机器人辅助技术可在四角融合术中准确放置螺钉并降低手术难度:一项尸体研究。
背景:本研究旨在探讨机器人辅助四角融合技术与传统徒手操作相比的可行性和准确性:本研究旨在探讨机器人辅助四角融合技术与传统徒手操作相比的可行性和准确性:方法:20 具尸体标本被随机分配到机器人辅助组和徒手组。采用机器人辅助或徒手技术,经皮放置三枚螺钉,分别固定每个标本的头帽-月骨关节、月骨-三喙突关节和三喙突-肱骨-头帽关节。机器人辅助组通过合并术中和术后 CT 扫描图像确定螺钉实际位置与计划位置之间的偏移。对两组患者的螺钉中心度、耗时、钻孔尝试和辐射暴露进行了比较:实际螺钉位置与计划螺钉位置的平均偏移量为 1.09 毫米(标度:0.56)。螺钉起点的偏移量明显低于终点。两组患者的螺钉中心度和手术时间没有明显差异。机器人辅助组的钻孔次数和外科医生接受的辐射剂量明显较低:虽然两组螺钉中心度没有明显差异,但实际螺钉位置与计划螺钉位置之间的轻微偏移证实了机器人辅助技术在四角融合中的可行性。机器人辅助技术在降低手术难度和保护外科医生免受大剂量辐射方面具有优势。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.10
自引率
7.70%
发文量
494
审稿时长
>12 weeks
期刊介绍: Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues. Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications. JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.
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