Safety and efficacy of orthopedic robots in total hip arthroplasty: a network meta-analysis and systematic review.

IF 2.8 3区医学 Q1 ORTHOPEDICS

Journal of Orthopaedic Surgery and Research Pub Date : 2024-12-19 DOI:10.1186/s13018-024-05279-6

Zhenhua Wu, Yin Zheng, Xiwei Zhang

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引用次数: 0

Abstract

Background: With the increasing demand for total hip arthroplasty (THA) and the inevitable trend of orthopedic robots and artificial intelligence in the future, it is necessary to explore the safety and effectiveness of orthopedic robots in THA. Currently, most orthopedic robots are in the early stages of development, and evaluating their clinical efficacy can assist in making informed decisions for practical use.

Objective: To explore the advantages of 7 types of robot-assisted THA with respect to 5 indicators.

Methods: Literature from databases such as CNKI, PubMed, and Web of Science was retrieved up to July 17, 2024. Literature evaluation was conducted via Review Manager 5.4, and a network meta-analysis was performed via RStudio (version 4.4.1).

Results: A total of 17 studies involving 1741 patients were included. In direct comparisons, the operation time was longer for MAKO (MD = 19; CI = 6.7, 31), TRex (MD = 37, CI = 20, 54) and YUANHUA (MD = 35, CI = 4.2, 66) than for C-THA. The leg length discrepancy (LLD) was smaller for TRex (MD = -3.4, CI = -6.6, -0.36) and RO (MD = -4.3, CI = -8.7, -0.064) than for C-THA. In the comprehensive best probability ranking, operation time [C-THA (96%) > TJ (68%) > RO (53.2%) > MAKO (53%) > LA (45%) > YU (21%) > TR (13%)], blood loss [TJ (89%) > C-THA (50%) > LA (49%) > YU (42%) > MAKO (20%)], LLD [RO (83%) > TR (75%) > MAKO (61%) > TJ (51%) > YU (43%) > JJ (40%) > C-THA (24%) > LA (22%)], HHS [RO (65%) > C-THA (55%) > LA (51%) > TR (50%) > JJ (48%) > YU (46%) > MAKO (37%)], and infection [TJ (77%) > C-THA (67%) > MAKO (44%) > RO (10%)].

Conclusion: Each of the seven types of RA-THA and C-THA has its own advantages, with TJ and RO RA-THA being slightly more prominent. Overall, in terms of safety and effectiveness, RA-THA is generally superior to C-THA, although further development is still needed.

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骨科机器人在全髋关节置换术中的安全性和有效性：一项网络荟萃分析和系统回顾。

背景：随着全髋关节置换术（THA）需求的不断增加，以及未来骨科机器人和人工智能的必然趋势，有必要探讨全髋关节置换术中骨科机器人的安全性和有效性。目前，大多数骨科机器人都处于开发的早期阶段，评估它们的临床疗效可以帮助做出明智的实际使用决策。目的：探讨7种机器人辅助THA在5项指标上的优势。方法：检索截至2024年7月17日的CNKI、PubMed、Web of Science等数据库的文献。通过Review Manager 5.4进行文献评估，并通过RStudio（版本4.4.1）进行网络荟萃分析。结果：共纳入17项研究，1741例患者。直接比较，MAKO手术时间较长(MD = 19；CI = 6.7, 31), TRex （MD = 37, CI = 20, 54）和YUANHUA （MD = 35, CI = 4.2, 66）均优于C-THA。TRex组（MD = -3.4, CI = -6.6, -0.36）和RO组（MD = -4.3, CI = -8.7, -0.064）的腿长差异（LLD）小于C-THA组。在综合排名最好的概率,操作时间(C-THA (96%) > TJ (68%) > RO(53.2%) >灰鲭鲨(53%)>拉(45%)> YU (21%) > TR(13%)],失血(TJ (89%) > C-THA(50%) >拉(49%)> YU(42%) >灰鲭鲨(20%)],LLD (RO (83%) > TR(75%) >灰鲭鲨(61%)> TJ (51%) > YU (43%) > JJ (40%) > C-THA(24%) >拉(22%)],美国卫生和公众服务部(RO (65%) > C-THA(55%) >拉(51%)> TR (50%) > JJ (48%) > YU(46%) >灰鲭鲨(37%)],和感染(TJ (77%) > C-THA(67%) >灰鲭鲨(44%)> RO(10%)]。结论：7种RA-THA和C-THA各有优势，TJ和RO RA-THA略显突出。总的来说，在安全性和有效性方面，RA-THA总体上优于C-THA，尽管还需要进一步的发展。

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

Journal of Orthopaedic Surgery and Research ORTHOPEDICS-

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.