A systematic review and meta-analysis comparing robotic-assisted percutaneous screw fixation and conventional surgical techniques for acetabular fractures.

Abstract

The objective of this comprehensive review and meta-analysis was to evaluate the effectiveness of robot-aided percutaneous screw fixation versus traditional surgical techniques in managing acetabular fractures. We plan to carry out an exhaustive exploration of certain databases (PubMed, CNKI, Embase, and Cochrane Library) to find studies that have been published since the beginning of these databases until August 2024, focusing on patients with acetabular fractures. These studies will compare the efficacy of robot-assisted percutaneous screw fixation with conventional surgical methods. Both English and Chinese literature will be included. We will adhere strictly to the predefined inclusion and exclusion criteria, with a focus on randomized controlled trials and cohort studies. Review Manager 5.4.1 will be utilized for the execution of data analysis. The ROBINS-I instrument will be used to evaluate the bias risk in Not-RCTs. The final analysis included 6 retrospective cohort studies, encompassing a total of 168 patients, with 83 undergoing robot-assisted percutaneous screw fixation and 85 receiving conventional surgery. The results indicated that patients treated with robot-assisted percutaneous screw fixation had shorter OT, fewer intraoperative fluoroscopy instances, and fewer adjustments of guide pins compared to those receiving conventional surgery. However, no significant differences were observed between the two treatment methods in terms of Modified Postel Merle D'Aubigne scores and EBL. The use of robots in percutaneous screw fixation has been demonstrated to be a secure and efficient method for managing acetabular fractures. Compared to conventional ORIF or free-hand screw fixation, this robotic-assisted technique offers significant advantages, including reduced operation time, lower IFF, and fewer guide wire adjustments.