High Degree of Accuracy of a Novel Image-free Handheld Robot for Unicondylar Knee Arthroplasty in a Cadaveric Study
Identifieur interne : 003129 ( Ncbi/Merge ); précédent : 003128; suivant : 003130High Degree of Accuracy of a Novel Image-free Handheld Robot for Unicondylar Knee Arthroplasty in a Cadaveric Study
Auteurs : Jess H. Lonner [États-Unis] ; Julie R. Smith [Royaume-Uni, États-Unis] ; Frederic Picard [Royaume-Uni] ; Brian Hamlin [États-Unis] ; Philip J. Rowe [Royaume-Uni] ; Philip E. Riches [Royaume-Uni]Source :
- Clinical Orthopaedics and Related Research [ 0009-921X ] ; 2014.
Abstract
Surgical robotics has been shown to improve the accuracy of bone preparation and soft tissue balance in unicondylar knee arthroplasty (UKA). However, although extensive data have emerged with regard to a CT scan-based haptically constrained robotic arm, little is known about the accuracy of a newer alternative, an imageless robotic system.
We assessed the accuracy of a novel imageless semiautonomous freehand robotic sculpting system in performing bone resection and preparation in UKA using cadaveric specimens.
In this controlled study, we compared the planned and final implant placement in 25 cadaveric specimens undergoing UKA using the new tool. A quantitative analysis was performed to determine the translational, angular, and rotational differences between the planned and achieved positions of the implants.
The femoral implant rotational mean error was 1.04° to 1.88° and mean translational error was 0.72 to 1.29 mm across the three planes. The tibial implant rotational mean error was 1.48° to 1.98° and the mean translational error was 0.79 to 1.27 mm across the three planes.
The image-free robotic sculpting tool achieved accurate implementation of the surgical plan with small errors in implant placement. The next step will be to determine whether accurate implant placement translates into a clinical and functional benefit for the patient.
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DOI: 10.1007/s11999-014-3764-x
PubMed: 25002214
PubMed Central: 4390929
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Lonner</name><affiliation wicri:level="2"><nlm:aff id="Aff1">Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, 925 Chestnut Street, Philadelphia, PA 19107 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, 925 Chestnut Street, Philadelphia</wicri:cityArea></affiliation></author><author><name sortKey="Smith, Julie R" sort="Smith, Julie R" uniqKey="Smith J" first="Julie R." last="Smith">Julie R. Smith</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Biomedical Engineering Department, University of Strathclyde, Wolfson Centre, Glasgow, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Biomedical Engineering Department, University of Strathclyde, Wolfson Centre, Glasgow</wicri:regionArea><wicri:noRegion>Glasgow</wicri:noRegion></affiliation><affiliation wicri:level="2"><nlm:aff id="Aff3">Blue Belt Technologies Inc, Plymouth, MN USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Minnesota</region></placeName><wicri:cityArea>Blue Belt Technologies Inc, Plymouth</wicri:cityArea></affiliation></author><author><name sortKey="Picard, Frederic" sort="Picard, Frederic" uniqKey="Picard F" first="Frederic" last="Picard">Frederic Picard</name><affiliation wicri:level="1"><nlm:aff id="Aff4">Department of Orthopaedics, Golden Jubilee National Hospital, Clydebank, Glasgow, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Orthopaedics, Golden Jubilee National Hospital, Clydebank, Glasgow</wicri:regionArea><wicri:noRegion>Glasgow</wicri:noRegion></affiliation></author><author><name sortKey="Hamlin, Brian" sort="Hamlin, Brian" uniqKey="Hamlin B" first="Brian" last="Hamlin">Brian Hamlin</name><affiliation wicri:level="2"><nlm:aff id="Aff5">The Bone & Joint Center, Magee-Womens Hospital of UPMC, Pittsburgh, PA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>The Bone & Joint Center, Magee-Womens Hospital of UPMC, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Rowe, Philip J" sort="Rowe, Philip J" uniqKey="Rowe P" first="Philip J." last="Rowe">Philip J. Rowe</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Biomedical Engineering Department, University of Strathclyde, Wolfson Centre, Glasgow, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Biomedical Engineering Department, University of Strathclyde, Wolfson Centre, Glasgow</wicri:regionArea><wicri:noRegion>Glasgow</wicri:noRegion></affiliation></author><author><name sortKey="Riches, Philip E" sort="Riches, Philip E" uniqKey="Riches P" first="Philip E." last="Riches">Philip E. Riches</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Biomedical Engineering Department, University of Strathclyde, Wolfson Centre, Glasgow, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Biomedical Engineering Department, University of Strathclyde, Wolfson Centre, Glasgow</wicri:regionArea><wicri:noRegion>Glasgow</wicri:noRegion></affiliation></author></analytic><series><title level="j">Clinical Orthopaedics and Related Research</title><idno type="ISSN">0009-921X</idno><idno type="eISSN">1528-1132</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Surgical robotics has been shown to improve the accuracy of bone preparation and soft tissue balance in unicondylar knee arthroplasty (UKA). However, although extensive data have emerged with regard to a CT scan-based haptically constrained robotic arm, little is known about the accuracy of a newer alternative, an imageless robotic system.</p></sec><sec><title>Questions/purposes</title><p>We assessed the accuracy of a novel imageless semiautonomous freehand robotic sculpting system in performing bone resection and preparation in UKA using cadaveric specimens.</p></sec><sec><title>Methods</title><p>In this controlled study, we compared the planned and final implant placement in 25 cadaveric specimens undergoing UKA using the new tool. A quantitative analysis was performed to determine the translational, angular, and rotational differences between the planned and achieved positions of the implants.</p></sec><sec><title>Results</title><p>The femoral implant rotational mean error was 1.04° to 1.88° and mean translational error was 0.72 to 1.29 mm across the three planes. The tibial implant rotational mean error was 1.48° to 1.98° and the mean translational error was 0.79 to 1.27 mm across the three planes.</p></sec><sec><title>Conclusions</title><p>The image-free robotic sculpting tool achieved accurate implementation of the surgical plan with small errors in implant placement. The next step will be to determine whether accurate implant placement translates into a clinical and functional benefit for the patient.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Clin Orthop Relat Res</journal-id><journal-id journal-id-type="iso-abbrev">Clin. Orthop. Relat. Res</journal-id><journal-title-group><journal-title>Clinical Orthopaedics and Related Research</journal-title></journal-title-group><issn pub-type="ppub">0009-921X</issn><issn pub-type="epub">1528-1132</issn><publisher><publisher-name>Springer US</publisher-name><publisher-loc>Boston</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25002214</article-id><article-id pub-id-type="pmc">4390929</article-id><article-id pub-id-type="publisher-id">3764</article-id><article-id pub-id-type="doi">10.1007/s11999-014-3764-x</article-id><article-categories><subj-group subj-group-type="heading"><subject>Symposium: 2014 Knee Society Proceedings</subject></subj-group></article-categories><title-group><article-title>High Degree of Accuracy of a Novel Image-free Handheld Robot for Unicondylar Knee Arthroplasty in a Cadaveric Study</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Lonner</surname><given-names>Jess H.</given-names></name><degrees>MD</degrees><address><email>jesslonner@comcast.net</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Smith</surname><given-names>Julie R.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="Aff2"></xref><xref ref-type="aff" rid="Aff3"></xref></contrib><contrib contrib-type="author"><name><surname>Picard</surname><given-names>Frederic</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="Aff4"></xref></contrib><contrib contrib-type="author"><name><surname>Hamlin</surname><given-names>Brian</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="Aff5"></xref></contrib><contrib contrib-type="author"><name><surname>Rowe</surname><given-names>Philip J.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Riches</surname><given-names>Philip E.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="Aff2"></xref></contrib><aff id="Aff1"><label></label>Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, 925 Chestnut Street, Philadelphia, PA 19107 USA</aff><aff id="Aff2"><label></label>Biomedical Engineering Department, University of Strathclyde, Wolfson Centre, Glasgow, UK</aff><aff id="Aff3"><label></label>Blue Belt Technologies Inc, Plymouth, MN USA</aff><aff id="Aff4"><label></label>Department of Orthopaedics, Golden Jubilee National Hospital, Clydebank, Glasgow, UK</aff><aff id="Aff5"><label></label>The Bone & Joint Center, Magee-Womens Hospital of UPMC, Pittsburgh, PA USA</aff></contrib-group><pub-date pub-type="epub"><day>8</day><month>7</month><year>2014</year></pub-date><pub-date pub-type="ppub"><month>1</month><year>2015</year></pub-date><volume>473</volume><issue>1</issue><fpage>206</fpage><lpage>212</lpage><permissions><copyright-statement>© The Association of Bone and Joint Surgeons® 2014</copyright-statement></permissions><abstract id="Abs1"><sec><title>Background</title><p>Surgical robotics has been shown to improve the accuracy of bone preparation and soft tissue balance in unicondylar knee arthroplasty (UKA). However, although extensive data have emerged with regard to a CT scan-based haptically constrained robotic arm, little is known about the accuracy of a newer alternative, an imageless robotic system.</p></sec><sec><title>Questions/purposes</title><p>We assessed the accuracy of a novel imageless semiautonomous freehand robotic sculpting system in performing bone resection and preparation in UKA using cadaveric specimens.</p></sec><sec><title>Methods</title><p>In this controlled study, we compared the planned and final implant placement in 25 cadaveric specimens undergoing UKA using the new tool. A quantitative analysis was performed to determine the translational, angular, and rotational differences between the planned and achieved positions of the implants.</p></sec><sec><title>Results</title><p>The femoral implant rotational mean error was 1.04° to 1.88° and mean translational error was 0.72 to 1.29 mm across the three planes. The tibial implant rotational mean error was 1.48° to 1.98° and the mean translational error was 0.79 to 1.27 mm across the three planes.</p></sec><sec><title>Conclusions</title><p>The image-free robotic sculpting tool achieved accurate implementation of the surgical plan with small errors in implant placement. The next step will be to determine whether accurate implant placement translates into a clinical and functional benefit for the patient.</p></sec></abstract><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Association of Bone and Joint Surgeons® 2015</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc><affiliations><list><country><li>Royaume-Uni</li><li>États-Unis</li></country><region><li>Minnesota</li><li>Pennsylvanie</li></region></list><tree><country name="États-Unis"><region name="Pennsylvanie"><name sortKey="Lonner, Jess H" sort="Lonner, Jess H" uniqKey="Lonner J" first="Jess H." last="Lonner">Jess H. Lonner</name></region><name sortKey="Hamlin, Brian" sort="Hamlin, Brian" uniqKey="Hamlin B" first="Brian" last="Hamlin">Brian Hamlin</name><name sortKey="Smith, Julie R" sort="Smith, Julie R" uniqKey="Smith J" first="Julie R." last="Smith">Julie R. Smith</name></country><country name="Royaume-Uni"><noRegion><name sortKey="Smith, Julie R" sort="Smith, Julie R" uniqKey="Smith J" first="Julie R." last="Smith">Julie R. Smith</name></noRegion><name sortKey="Picard, Frederic" sort="Picard, Frederic" uniqKey="Picard F" first="Frederic" last="Picard">Frederic Picard</name><name sortKey="Riches, Philip E" sort="Riches, Philip E" uniqKey="Riches P" first="Philip E." last="Riches">Philip E. Riches</name><name sortKey="Rowe, Philip J" sort="Rowe, Philip J" uniqKey="Rowe P" first="Philip J." last="Rowe">Philip J. Rowe</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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