Robotic-assisted unicompartmental knee arthroplasty: a review

Liu, Pei; Lu, Feifan; Liu, Guojie; Mu, Xiaohong; Sun, Yu; Zhang, Qidong; Wang, Weiguo; Guo, Wanshou

doi:10.1186/s42836-021-00071-x

Cited by 18 publications

(12 citation statements)

References 70 publications

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“…With the development and updating of medical imaging and computer technologies, computer‐assisted orthopaedic surgery has been widely used in joint surgery, spine surgery, and traumatic orthopaedics 20 . The stereotactic technique based on X‐ray or three‐dimensional (3D) CT images can assist surgeons in planning surgeries more precisely, improving surgical efficiency and accuracy, reducing radiation exposure, and reducing patient injury 32 . However, computer‐assisted orthopaedic surgery is not perfect 24 .…”

Section: Discussionmentioning

confidence: 99%

“…20 The stereotactic technique based on X-ray or three-dimensional (3D) CT images can assist surgeons in planning surgeries more precisely, improving surgical efficiency and accuracy, reducing radiation A B FIGURE 11 Raw data of Ar, mean AE SD of Ar, and significant difference analysis results of five drilling states on specimen 4 exposure, and reducing patient injury. 32 However, computerassisted orthopaedic surgery is not perfect. 24 Current computer-assisted orthopaedic surgery has limitations in terms of positioning and navigation.…”

Section: Challenges Of Drilling Task In Traditional Hip Fractures Fix...mentioning

confidence: 99%

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Surgical Tool Handle Vibration‐Based Drilling State Recognition During Hip Fracture Fixation

Xia¹,

Liu

Bai

et al. 2022

Orthopaedic Surgery

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Objectives Traditional manual drilling during hip fracture fixation can easily lead to unstable fixation and vascular damage. This study aimed to investigate a safe and easy‐to‐use robot‐assisted method to automatically drill bone and distinguish critical bone drilling states with high accuracy in real‐time for the bone hole‐making process during hip fracture fixation. Methods A bone‐drilling robotic system was designed to automatically create holes in the femoral neck. Four fresh pig femurs were drilled at the posterosuperior femoral neck using three modes: “all‐in” (AI), “in‐out‐in” (IOI), and “percutaneous fixation” (PF). A high‐frequency accelerometer captured the generated vibrations of the drill handle, which were then transferred to a personal computer using a data acquisition card. Five bone drilling states are defined, including: “drill idling,” “initial drilling,” “in the cancellous bone,” “out the femoral neck,” and “in the cortical bone.” The harmonic distribution of the vibration signal was extracted by fast Fourier transform (FFT) and used as a critical feature to identify different drilling states. To prove the difference in the harmonic distribution at different drilling states, an independent sample t‐test was used to compare the percentage of the first harmonic amplitude in the first 10 harmonics at each drilling state. A neural network classifier was trained with the frequency spectrum as the input and the drilled state as the output to distinguish the critical bone drilling states with high accuracy in real‐time. The classifier was trained and tested on four specimens to ensure that the surgical robot could accurately identify the five drilling states. Results In each specimen, the harmonic distributions of the drilling vibration at different drilling modes were significantly different (p < 0.05). The average recognition accuracies of the drilling state for the four specimens were all higher than 84%. The three defined modes were distinguished with extremely high accuracies. The recognition accuracies of “in the cancellous bone” for specimens 1 to 4 were 83.2%, 84.8%, 92.9%, and 84.7%. The recognition accuracies of “in out the femoral neck” from specimens 1 to 4 are 98.2%, 88.4%, 95.8%, and 88.8%. The recognition accuracies of “in the cortical bone” for specimens 1 to 4 were 94.6%, 80.8%, 95.5%, and 85.8%. Conclusions The proposed robot‐assisted method can automatically distinguish five critical bone‐drilling states with high accuracy in real‐time to avoid weak fixation and damage to the lateral epiphyseal artery.

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Section: Discussionmentioning

confidence: 99%

Section: Challenges Of Drilling Task In Traditional Hip Fractures Fix...mentioning

confidence: 99%

Surgical Tool Handle Vibration‐Based Drilling State Recognition During Hip Fracture Fixation

Xia¹,

Liu

Bai

et al. 2022

Orthopaedic Surgery

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“…Robotic technology can help facilitate partial knee replacements, as partial knee replacements are very technically challenging to do manually even for the most experienced surgeons. Research studies suggest that robotic technology significantly improves alignment, the precision of bone preparation and implant placement, and reduces technical variability and outliers [ 18 ], with some evidence supporting improved ROM and lower revision rates, but with increased surgery time and cost [ 23 ]. There is limited evidence on implant survival and long-term clinical outcomes [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

“…Research studies suggest that robotic technology significantly improves alignment, the precision of bone preparation and implant placement, and reduces technical variability and outliers [ 18 ], with some evidence supporting improved ROM and lower revision rates, but with increased surgery time and cost [ 23 ]. There is limited evidence on implant survival and long-term clinical outcomes [ 18 ]. One small cohort study evaluated 53 consecutive robot-assisted BiKA procedures at a single center with findings supporting successful survivorship at 5 and 7 years, predominantly excellent postoperative functional outcomes, and overall good patient satisfaction [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

Robot-assisted partial knee replacement versus standard total knee replacement (RoboKnees): a protocol for a pilot randomized controlled trial

Madden,

Flood,

Malek

et al. 2024

Pilot Feasibility Stud

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Background Total knee arthroplasty is a common surgery for end-stage knee osteoarthritis. Partial knee arthroplasty is also a treatment option for patients with arthritis present in only one or two knee compartments. Partial knee arthroplasty can preserve the natural knee biomechanics, but these replacements may not last as long as total knee replacements. Robotic-assisted orthopedic techniques can help facilitate partial knee replacements, increasing accuracy and precision. This trial will investigate the feasibility and assess clinical outcomes for a larger definitive trial. Methods This is a protocol for an ongoing parallel randomized pilot trial of 64 patients with uni- or bicompartmental knee arthritis. Patients are randomized to either receive robot-assisted partial knee arthroplasty or manual total knee arthroplasty. The primary outcome of this pilot is investigating the feasibility of a larger trial. Secondary (clinical) outcomes include joint awareness, return to activities, knee function, patient global impression of change, persistent post-surgical pain, re-operations, resource utilization and cost-effectiveness, health-related quality of life, radiographic alignment, knee kinematics during walking gait, and complications up to 24 months post-surgery. Discussion The RoboKnees pilot study is the first step in determining the outcome of robot-assisted partial knee replacements. Conclusions from this study will be used to design future large-scale trials. This study will inform surgeons about the potential benefits of robot-assisted partial knee replacements. Trial registration This study was prospectively registered on clinicaltrials.gov (identifier: NCT04378049) on 4 May 2020, before the first patient was randomized.

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“…It is indisputable that precision is higher with the help of these technologies compared to conventional jigs and eye-balling, even compared to experienced surgeons. However, thorough planning is mandatory to avoid a possible “trash in—trash-out” effect [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ].…”

mentioning

confidence: 99%