1
|
Wang M, Zheng S, Zhang Y, Lu J. Analysis of the therapeutic efficacy of robot-assisted percutaneous screw fixation in the minimally invasive treatment of pelvic fractures. Front Surg 2024; 11:1392719. [PMID: 39022596 PMCID: PMC11251939 DOI: 10.3389/fsurg.2024.1392719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 06/17/2024] [Indexed: 07/20/2024] Open
Abstract
Objective To compare the therapeutic efficacy of robot-assisted and manual screw placement techniques for the treatment of pelvic fractures. Methods This study included patients with pelvic fractures admitted to our orthopedic department between January 2020 and January 2022. They were randomly assigned to either the robot-assisted group or the control group. Various parameters, including surgical duration, intraoperative bleeding, fluoroscopy frequency, postoperative pain, length of hospitalization, postoperative hematological indices, postoperative functional scores, and postoperative complications, were compared between the two groups. Results There were no significant differences in age, sex, body mass index, and preoperative hematological parameters between the two groups. The robot-assisted group exhibited significantly shorter surgical duration, lower fluoroscopy frequencies, lower postoperative pain scores, and shorter length of hospitalization compared to the control group. At 3 and 6 months postoperatively, patients in the robot-assisted group demonstrated significantly higher Majeed functional scores in comparison to the control group. However, there were no significant differences in Majeed scores at 12 months postoperatively. Moreover, there were no significant differences in postoperative complications between the two groups. Conclusion Robot-assisted minimally invasive treatment of pelvic fractures using hollow screws effectively reduced surgical duration, mitigated intraoperative bleeding and postoperative pain, shortened hospital stays, and promoted faster functional recovery.
Collapse
Affiliation(s)
| | | | | | - Jialing Lu
- Department of Traumatic and Pediatric Orthopedics, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, China
| |
Collapse
|
2
|
Zha Q, Xu Z, Yang H, Zhang G, Cai X, Zhang W, Liu Y, Shen X, Li Y. Development of a robot-assisted reduction and rehabilitation system for distal radius fractures. Front Bioeng Biotechnol 2024; 11:1342229. [PMID: 38268941 PMCID: PMC10805860 DOI: 10.3389/fbioe.2023.1342229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/26/2023] [Indexed: 01/26/2024] Open
Abstract
Background: Closed reduction is the preferred treatment for distal radius fractures. However, it requires a multiple experienced medical staff and manually maintaining stable traction is difficult. Additionally, doctors cannot assess the reduction status of a fracture in real-time through radiographic images, which may lead to improper reduction. Furthermore, post-fracture complications such as joint adhesion, stiffness, and impaired mobility pose a challenge for the doctors. So it is necessary to optimize the treatment process of the distal radius fracture through technological means. Methods: A robot-assisted closed reduction and rehabilitation system, which could assist doctors throughout the entire process of reduction, fixation, and rehabilitation of distal radius fractures, was developed. A mechanical system, composed of two grippers and a cooperative robotic arm, was used to grasp and tract the affected limb. A doctor controlled the robot through a joystick console and Windows application program. A biplane radiographic device was integrated into the system, which is not only convenient for doctors to view radiographic images of the fracture at any time but also for them to select the rotation axis of the wrist on the images before reduction and rehabilitation. Important information including the anteroposterior and lateral radiographic data and force and position parameters during the reduction and rehabilitation process were displayed on a graphic user interface. Results: Experimental results showed that the proposed robotic system can meet the technical requirements for the reduction and rehabilitation of distal radius fractures, all the rotation angles could be achieved, a maximum force of more than 50 N could be achieved in all traction directions, and the error in selecting the wrist joint rotation axis line using radiographic images was less than 5 mm. Conclusion: The developed robot-assisted system was shown to be suitable for closed reduction and rehabilitation of distal radius fractures, contributing a potential improvement in the quality of the procedures.
Collapse
Affiliation(s)
- Qing Zha
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, China
| | - Zeou Xu
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, China
| | - Hongbo Yang
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, China
| | - Guodong Zhang
- Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Xuefeng Cai
- Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Wanlin Zhang
- Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Yujiang Liu
- Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Xiaofeng Shen
- Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Yuwei Li
- Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| |
Collapse
|
3
|
Liu D, Liang J, Yang H. A novel technology integrating robotics and 3D printing for closed reduction of tibia shaft fracture with MIPPO:A proof-of-concept study. Med Eng Phys 2024; 123:104079. [PMID: 38365332 DOI: 10.1016/j.medengphy.2023.104079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 11/16/2023] [Accepted: 12/03/2023] [Indexed: 02/18/2024]
Abstract
Less invasive fixation techniques, such as intramedullary nailing (IMN) and minimally invasive percutaneous plate osteosynthesis (MIPPO), are now the preferred choices for treating tibia shaft fractures (TSFs). However, malreduction and radiation exposure are the main deficiencies associated with less invasive fixation techniques, especially when assessing rotation around the shaft axis intra-operatively. The purpose of this study was to investigate the feasibility and reduction accuracy of an innovative technology that integrates robotics and 3D printing for achieving anatomical reduction of TSFs with MIPPO. The surgical workflow from a standardized CT protocol, via 3D reconstruction, 3D printing tibia model, pre-contouring plate, 3D scanning plate, 3D planning of the trajectories of the robot, and use of a commercial surgical robot, robot-assisted screw hole drilling, to automatic fracture reduction through precise installation of the plate was described. The reduction accuracy was evaluated by an optical tracking system. The mean variations of 1.95 ± 1.36mm in length, 1.63 ± 0.92 mm in apposition, 2.78 ± 1.69° in alignment, and 1.99 ± 1.81° in rotation. The interoperator reliabilities were almost perfect, with values of 0.91, 0.93, 0.92, and 0.90, respectively. The proposed technology achieved anatomic reduction on phantom bones.
Collapse
Affiliation(s)
- Dapeng Liu
- Department of Orthopedics, The Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
| | - Jinghao Liang
- Department of Orthopedics, Xinjiang Cardiovascular and Cerebrovascular Disease Hospital, Urumqi, China
| | - Hongju Yang
- Department of Surgical Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| |
Collapse
|
4
|
Widanage KND, De Silva MJ, Dulantha Lalitharatne T, Bull AMJ, Gopura RARC. Developments in circular external fixators: A review. Injury 2023; 54:111157. [PMID: 37951162 DOI: 10.1016/j.injury.2023.111157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 10/23/2023] [Accepted: 10/23/2023] [Indexed: 11/13/2023]
Abstract
Circular external fixators (CEFs) are successfully used in orthopedics owing to their highly favorable stiffness characteristics which promote distraction osteogenesis. Although there are different designs of external fixators, how these features produce optimal biomechanics through structural and component designs is not well known. Therefore, the aim of this study was to conduct a review on CEFs following the PRISMA statement. A search for relevant research articles was performed on Scopus and PubMed databases providing the related keywords. Furthermore, a patent search was conducted on the Google Patent database. 126 records were found to be eligible for the review. Different designs of CEFs were summarized and tabulated based on their specific features. A bibliometric analysis was also performed on the eligible research papers. Based on the findings, the developments of CEFs in terms of materials, automation, adjustment methods, component designs, wire-clamping, and performance evaluation have been extensively discussed. The trends of the CEF design and future directions are also discussed in this review. Significant research gaps include a lack of consideration towards ease of assembly, effective wire-clamping methods, and CEFs embedded with online patient-monitoring systems, among others. An apparent lack of research interest from low-middle and low-income countries was also identified.
Collapse
Affiliation(s)
- Kithmi N D Widanage
- Department of Engineering and Design, University of Sussex, Falmer, Brighton, BN1 9RH, United Kingdom; Department of Mechanical Engineering, University of Moratuwa, Moratuwa, 10400, Sri Lanka.
| | | | | | - Anthony M J Bull
- Department of Bioengineering, Imperial College London, London, SW7 2BX, United Kingdom
| | - R A R C Gopura
- Department of Mechanical Engineering, University of Moratuwa, Moratuwa, 10400, Sri Lanka
| |
Collapse
|
5
|
Bang H, Park CW, Joung S, Lee HJ, Park IH. Clinical evaluation of a fluoroscopic image-based laser guidance system in bone tumor surgery: A technical note. Med Eng Phys 2023; 120:104056. [PMID: 37838405 DOI: 10.1016/j.medengphy.2023.104056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 09/14/2023] [Accepted: 09/18/2023] [Indexed: 10/16/2023]
Abstract
This study presents a laser guidance system developed to enhance surgical accuracy and reduce radiation exposure in orthopedic surgeries. The system can project the actual position corresponding to the appointed position selected by the surgeon on a fluoroscopic image using a line laser and has laser projection ability to mark the corresponding point using a line laser. The surgeon does not have to perform anatomical marker placement for calibration. Three patients with bone tumors underwent surgeries using the laser guidance system, and the projection accuracy was evaluated by measuring the distance error between the appointed and laser-marking positions. The installation time, including calibration, was also assessed for clinical usability. The average projection accuracy in bone tumor surgery was 2.86 mm, and the average installation time was 7 min. These results demonstrate that the laser guidance system, with a projection error of <3 mm, could be useful in bone tumor surgeries.
Collapse
Affiliation(s)
- Hyunhee Bang
- Medical Device and Robot Institute of Park, Kyungpook National University, 1006 Global plaza, 80 Daehakro, Bukgu, Daegu 41566, South Korea
| | - Chul Woo Park
- Medical Device and Robot Institute of Park, Kyungpook National University, 1006 Global plaza, 80 Daehakro, Bukgu, Daegu 41566, South Korea
| | - Sanghyun Joung
- Medical Device and Robot Institute of Park, Kyungpook National University, 1006 Global plaza, 80 Daehakro, Bukgu, Daegu 41566, South Korea
| | - Hyun-Joo Lee
- Medical Device and Robot Institute of Park, Kyungpook National University, 1006 Global plaza, 80 Daehakro, Bukgu, Daegu 41566, South Korea; Department of Orthopedic surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Dongduk-ro, 130, Jung-gu, Daegu 41944, South Korea.
| | - Il-Hyung Park
- Medical Device and Robot Institute of Park, Kyungpook National University, 1006 Global plaza, 80 Daehakro, Bukgu, Daegu 41566, South Korea; Department of Orthopedic surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Dongduk-ro, 130, Jung-gu, Daegu 41944, South Korea.
| |
Collapse
|
6
|
Li G, Tang X, Li J, Dong M. Error identification and compensation regarding the kinematic parameter of the MD-PEF for tibial deformity correction. Comput Biol Med 2023; 158:106813. [PMID: 36966553 DOI: 10.1016/j.compbiomed.2023.106813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 02/18/2023] [Accepted: 03/20/2023] [Indexed: 03/31/2023]
Abstract
The correction accuracy of an external fixator is crucial to the treatment outcome of deformity correction and patient safety. In this study, the mapping model is established between the pose error and kinematic parameter error of the motor-driven parallel external fixator (MD-PEF). Subsequently, the kinematic parameter identification and error compensation algorithm of the external fixator is established based on the least squares method. An experimental platform based on the developed MD-PEF and Vicon motion capture system is constructed for kinematic calibration experiments. Experimental results show that the correction accuracy of the MD-PEF after calibration is as follows: translation accuracy dE1 = 0.36 mm, axial translation accuracy dE2 = 0.25 mm, angulation accuracy dE3 = 0.27°, and rotation accuracy dE4 = 0.2°. The accuracy detection experiment verifies the kinematic calibration results, which further validates the feasibility and reliability of the error identification and compensation algorithm constructed by the least squares method. The calibration approach used in this work also provides an effective way to improve the accuracy of other medical robots.
Collapse
|
7
|
Zhao C, Cao Q, Sun X, Wu X, Zhu G, Wang Y. Intelligent robot-assisted minimally invasive reduction system for reduction of unstable pelvic fractures. Injury 2023; 54:604-614. [PMID: 36371315 DOI: 10.1016/j.injury.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 07/15/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Currently, minimally invasive internal fixation is recommended for the surgical treatment of unstable pelvic fractures. The premise and difficulty of minimally invasive internal fixation are minimally invasive reduction of fractures. This review aimed to investigate the indications, surgical strategy and techniques, safety, and efficacy of intelligent robot-assisted fracture reduction (RAFR) system of pelvic ring injuries. METHODS This retrospective study reviewed a case series from March 2021 to November 2021. A total of 22 patients with unstable pelvic fracture injuries underwent minimally invasive internal fixations. All pelvic ring fractures were reduced with our intelligent RAFR system. The robot system intelligently designs the optimal position and reduction path based on the patient's preoperative 3D CT. During the operation, the three-dimensional visualization of the fracture is realized through image registration, and the Robot completes the automatic reduction of the fracture. The global 3D point cloud error between the preoperative planning results and the actual postoperative reduction results was calculated. The postoperative reduction results of residual displacement were graded by the Matta Criteria. RESULTS Minimally invasive closed reduction procedures were completed in all 22 cases with our RAFR system. The average global 3D point cloud reduction error between the preoperative planning results and the actual postoperative reduction results was 3.41mm±1.83mm. The mean residual displacement was 4.61mm±3.29mm. Given the Matta criteria, 16 cases were excellent, five were good, and one was fair, with an excellent and good rate of 95.5%. CONCLUSION Our new pelvic fracture reduction robot system can complete intelligent and minimally invasive fracture reduction for most patients with unstable pelvic fractures. The system has intelligent reduction position and path planning and realizes stable pelvis control through a unique holding arm and a robotic arm. The operation process will not cause additional damage to the patient, which fully meets the clinical requirements. Our study demonstrated the safety and effectiveness of our robotic reduction system and its applicability and usability in clinical practice, thus paving the way towards Robot minimally invasive pelvic fracture surgeries.
Collapse
Affiliation(s)
- Chunpeng Zhao
- Department of Orthopedics and Traumatology, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Qiyong Cao
- Department of Orthopedics and Traumatology, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Xu Sun
- Department of Orthopedics and Traumatology, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Xinbao Wu
- Department of Orthopedics and Traumatology, Beijing Jishuitan Hospital, Beijing 100035, China.
| | - Gang Zhu
- Rossum Robot Co., Ltd., Beijing 100083, China
| | - Yu Wang
- School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China; Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing 100083, China
| |
Collapse
|
8
|
Liu J, Yan Y, Xu K, Zhao C, Wang Y, Wu X, Tian W. Biomechanical analysis of pelvic holding pathways and strategies for use of the steinmann pin in pelvic fracture reduction. Comput Biol Med 2023; 152:106310. [PMID: 36462368 DOI: 10.1016/j.compbiomed.2022.106310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 11/06/2022] [Accepted: 11/13/2022] [Indexed: 11/29/2022]
Abstract
Pelvic fracture is the most serious bone trauma and has the highest mortality and disability rate. Surgical treatment of pelvic fracture is very challenging for surgeons. Minimally invasive close reduction of pelvic fracture is considered the most difficult operation due to the complex pelvic morphology and abundant soft tissue anatomy, both of which increase the difficulty of pelvic fracture reduction. The most challenging aspect of such surgery is how to hold the pelvic bone and effectively transmit the reduction force to the bone. Therefore, a safe and effective pelvic holding pathway for reduction is necessary for pelvic fracture operations. Existing research on the pelvic holding pathway addresses anatomical position and dimension. Few studies have focused on biomechanical properties or on surgical techniques related to these pathways. This paper studies the three holding pathways that are most commonly used in clinical practice. The most effective force direction for each holding pathway is identified through finite element modeling. Pathway 1 is suitable for internal rotation operation and open/close-book operation of the pelvis; Pathway 2 is suitable for translation of the fractured pelvis toward the sacrum and internal pelvic rotation operations; Pathway 3 is suitable for pulling and lifting of the fractured pelvis against gravity and open/close-book operation of the pelvis. In addition, we find through our simulation that the use of a combined holding strategy can reduce the reduction force during the reduction process. We compared the performances of the 2-pin combined holding strategy (2P-CH) and the 3-pin combined strategy (3P-CH). During translational reduction, 2P-CH and 3P-CH showed little difference in pelvic reduction force. However, in rotational reduction, 3P-CH shows advantages. It has less reduction force and the least combined muscle resistance. It can also maximize the displacement of the iliac crest under the same conditions. The results of this study can be applied to surgical planning and to the development of robot-assisted surgery systems in selecting holding pathways and operation strategies for fractured pelvis.
Collapse
Affiliation(s)
- Jixuan Liu
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100083, China
| | - Yadong Yan
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100083, China
| | - Ke Xu
- Beijing Rossumrobot Ltd., Beijing, China
| | | | - Yu Wang
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100083, China.
| | - Xinbao Wu
- Beijing Jishuitan Hospital, Beijing, China
| | - Wei Tian
- Beijing Jishuitan Hospital, Beijing, China
| |
Collapse
|
9
|
Zhao B, Li J, Zhao C, Su Y, Han W, Wu X, Jiang X, Wang J. [Orthopedic robot based on 5G technology for remote navigation of percutaneous screw fixation in pelvic and acetabular fractures]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2022; 36:923-928. [PMID: 35979780 DOI: 10.7507/1002-1892.202204073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective To investigate the accuracy and safety of percutaneous screw fixation for pelvic and acetabular fractures with remote navigation of orthopedic robot based on 5G technology. Methods Between January 2021 and December 2021, 15 patients with pelvic and/or acetabular fractures were treated with percutaneous screws fixation which were placed by remote navigation of orthopedic robot based on 5G technology. There were 8 males and 7 females. The age ranged from 20 to 98 years, with an average of 52.1 years. The causes of trauma included traffic accident injury in 6 cases, falling from height injury in 6 cases, fall injury in 2 cases, and heavy object smashing injury in 1 case. The time from injury to operation ranged from 3 to 32 days, with an average of 10.9 days. There were 8 cases of simple pelvic fractures, 2 simple acetabular fractures, and 5 both pelvic and acetabular fractures. There were 7 cases of pelvic fractures of Tile type B2, 2 type B3, 1 type C1, and 3 type C2; 4 cases of unilateral anterior column fracture of the acetabulum, 2 bilateral anterior column fractures, and 1 anterior wall fracture. CT images within 5 days after operation were collected for screw position assessment. The screw planning time and guidewire placement time were recorded, as well as the presence of intraoperative adverse events and complications within 5 days after operation. Results All patients achieved satisfactory surgical results. A total of 36 percutaneous screws were inserted (20 sacroiliac screws, 6 LC Ⅱ screws, 9 anterior column screws, and 1 acetabular apical screw). In terms of screw position evaluation, 32 screws (88.89%) were excellent and 4 screws (11.11%) were good; there was no screw penetrating cortical bone. The screw planning time ranged from 4 to 15 minutes, with an average of 8.7 minutes. The guidewire placement time ranged from 3 to 10 minutes, with an average of 6.8 minutes. The communication delayed in 2 cases, but the operation progress was not affected, and no serious intraoperative adverse events occurred. No delayed vascular or nerve injury, infection, or other complications occurred within 5 days after operation. No cases need surgical revision. Conclusion The fixation of pelvic and acetabular fractures by percutaneous screw with remote navigation of orthopedic robot based on 5G technology is accurate, safe, and reliable.
Collapse
Affiliation(s)
- Bin Zhao
- Department of Orthopaedic Trauma, Beijing Jishuitan Hospital, Beijing, 100035, P. R. China
| | - Jinqi Li
- Department of Orthopaedic Trauma, Beijing Jishuitan Hospital, Beijing, 100035, P. R. China
| | - Chunpeng Zhao
- Department of Orthopaedic Trauma, Beijing Jishuitan Hospital, Beijing, 100035, P. R. China
| | - Yonggang Su
- Department of Orthopaedic Trauma, Beijing Jishuitan Hospital, Beijing, 100035, P. R. China
| | - Wei Han
- Department of Orthopaedic Trauma, Beijing Jishuitan Hospital, Beijing, 100035, P. R. China
| | - Xinbao Wu
- Department of Orthopaedic Trauma, Beijing Jishuitan Hospital, Beijing, 100035, P. R. China
| | - Xieyuan Jiang
- Department of Orthopaedic Trauma, Beijing Jishuitan Hospital, Beijing, 100035, P. R. China
| | - Junqiang Wang
- Department of Orthopaedic Trauma, Beijing Jishuitan Hospital, Beijing, 100035, P. R. China
| |
Collapse
|
10
|
Study on the Modeling and Compensation Method of Pose Error Analysis for the Fracture Reduction Robot. MICROMACHINES 2022; 13:mi13081186. [PMID: 36014108 PMCID: PMC9413538 DOI: 10.3390/mi13081186] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 07/23/2022] [Accepted: 07/25/2022] [Indexed: 01/27/2023]
Abstract
Background: In the process of fracture reduction, there are some errors between the actual trajectory and the ideal trajectory due to mechanism errors, which would affect the smooth operation of fracture reduction. To this end, based on self-developed parallel mechanism fracture reduction robot (FRR), a novel method to reduce the pose errors of FRR is proposed. Methods: Firstly, this paper analyzed the pose errors, and built the model of the robot pose errors. Secondly, mechanism errors of FRR were converted into drive bar parameter’s errors, and the influence of each drive bar parameter on the robot pose error were analyzed. Thirdly, combining with Cauchy opposition-based learning and differential evolution algorithm (DE), an improved whale optimization algorithm (CRLWOA-DE) is proposed to compensate the end-effector’s pose errors, which could improve the speed and accuracy of fracture reduction, respectively. Results: The iterative accuracy of CRLWOA-DE is improved by 50.74%, and the optimization speed is improved by 22.62% compared with the whale optimization algorithm (WOA). Meanwhile, compared with particle swarm optimization (PSO) and ant colony optimization (ACO), CRLWOA-DE is proved to be more accurate. Furthermore, SimMechanics in the software of MATLAB was used to reconstruct the fracture reduction robot, and it was verified that the actual motion trajectory of the CRLWOA-DE optimized kinematic stage showed a significant reduction in error in both the x-axis and z-axis directions compared to the desired motion trajectory. Conclusions: This study revealed that the error compensation in FRR reset process had been realized, and the CRLWOA-DE method could be used for reducing the pose error of the fracture reduction robot, which has some significance for the bone fracture and deformity correction.
Collapse
|
11
|
Tao B, Feng Y, Fan X, Zhuang M, Chen X, Wang F, Wu Y. Accuracy of dental implant surgery using dynamic navigation and robotic systems: An in vitro study. J Dent 2022; 123:104170. [DOI: 10.1016/j.jdent.2022.104170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 04/21/2022] [Accepted: 05/31/2022] [Indexed: 10/18/2022] Open
|
12
|
Kordon F, Maier A, Swartman B, Privalov M, El Barbari JS, Kunze H. Multi-Stage Platform for (Semi-)Automatic Planning in Reconstructive Orthopedic Surgery. J Imaging 2022; 8:jimaging8040108. [PMID: 35448235 PMCID: PMC9027971 DOI: 10.3390/jimaging8040108] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/05/2022] [Accepted: 04/08/2022] [Indexed: 01/11/2023] Open
Abstract
Intricate lesions of the musculoskeletal system require reconstructive orthopedic surgery to restore the correct biomechanics. Careful pre-operative planning of the surgical steps on 2D image data is an essential tool to increase the precision and safety of these operations. However, the plan’s effectiveness in the intra-operative workflow is challenged by unpredictable patient and device positioning and complex registration protocols. Here, we develop and analyze a multi-stage algorithm that combines deep learning-based anatomical feature detection and geometric post-processing to enable accurate pre- and intra-operative surgery planning on 2D X-ray images. The algorithm allows granular control over each element of the planning geometry, enabling real-time adjustments directly in the operating room (OR). In the method evaluation of three ligament reconstruction tasks effect on the knee joint, we found high spatial precision in drilling point localization (ε<2.9mm) and low angulation errors for k-wire instrumentation (ε<0.75∘) on 38 diagnostic radiographs. Comparable precision was demonstrated in 15 complex intra-operative trauma cases suffering from strong implant overlap and multi-anatomy exposure. Furthermore, we found that the diverse feature detection tasks can be efficiently solved with a multi-task network topology, improving precision over the single-task case. Our platform will help overcome the limitations of current clinical practice and foster surgical plan generation and adjustment directly in the OR, ultimately motivating the development of novel 2D planning guidelines.
Collapse
Affiliation(s)
- Florian Kordon
- Pattern Recognition Lab, Friedrich-Alexander University Erlangen-Nuremberg, 91058 Erlangen, Germany; (A.M.); (H.K.)
- Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander University Erlangen-Nuremberg, 91052 Erlangen, Germany
- Advanced Therapies, Siemens Healthcare GmbH, 91031 Forchheim, Germany
- Correspondence:
| | - Andreas Maier
- Pattern Recognition Lab, Friedrich-Alexander University Erlangen-Nuremberg, 91058 Erlangen, Germany; (A.M.); (H.K.)
- Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander University Erlangen-Nuremberg, 91052 Erlangen, Germany
| | - Benedict Swartman
- Department for Trauma and Orthopaedic Surgery, BG Trauma Center, Ludwigshafen, 67071 Ludwigshafen, Germany; (B.S.); (M.P.); (J.S.E.B.)
| | - Maxim Privalov
- Department for Trauma and Orthopaedic Surgery, BG Trauma Center, Ludwigshafen, 67071 Ludwigshafen, Germany; (B.S.); (M.P.); (J.S.E.B.)
| | - Jan Siad El Barbari
- Department for Trauma and Orthopaedic Surgery, BG Trauma Center, Ludwigshafen, 67071 Ludwigshafen, Germany; (B.S.); (M.P.); (J.S.E.B.)
| | - Holger Kunze
- Pattern Recognition Lab, Friedrich-Alexander University Erlangen-Nuremberg, 91058 Erlangen, Germany; (A.M.); (H.K.)
- Advanced Therapies, Siemens Healthcare GmbH, 91031 Forchheim, Germany
| |
Collapse
|
13
|
Cui R, Li J, Jiang Y, Sun H, Tan Y, Duan L, Wu M. Trajectory optimisation with musculoskeletal integration features for fracture reduction orthopaedic robot. Int J Med Robot 2022; 18:e2372. [DOI: 10.1002/rcs.2372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/26/2021] [Accepted: 10/26/2021] [Indexed: 11/07/2022]
Affiliation(s)
- Rui Cui
- School of Artificial Intelligence and Data Science and Engineering Research Center of Intelligent Rehabilitation Device and Detection Technology Ministry of Education, Hebei University of Technology Tianjin China
| | - Jian Li
- School of Automation Beijing University of Posts and Telecommunications Beijing China
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old‐Age Disability and Key Laboratory of Neuro‐functional Information and Rehabilitation Engineering of the Ministry of Civil Affairs National Research Center for Rehabilitation Technical Aids Beijing China
| | - Yongkang Jiang
- Shenzhen Institute of Advanced Technology Chinese Academy of Science Shenzhen China
| | - Hao Sun
- School of Artificial Intelligence and Data Science and Engineering Research Center of Intelligent Rehabilitation Device and Detection Technology Ministry of Education, Hebei University of Technology Tianjin China
| | - Yinglun Tan
- School of Artificial Intelligence and Data Science and Engineering Research Center of Intelligent Rehabilitation Device and Detection Technology Ministry of Education, Hebei University of Technology Tianjin China
| | - Lunhui Duan
- School of Artificial Intelligence and Data Science and Engineering Research Center of Intelligent Rehabilitation Device and Detection Technology Ministry of Education, Hebei University of Technology Tianjin China
| | - Mengkun Wu
- School of Artificial Intelligence and Data Science and Engineering Research Center of Intelligent Rehabilitation Device and Detection Technology Ministry of Education, Hebei University of Technology Tianjin China
| |
Collapse
|
14
|
Lee S, Joung S, Ha HG, Lee JH, Park KH, Kim S, Nam K, Lee J, Lee HJ, Oh CW, Park I, Hong J. 3D Image-Guided Robotic System for Bone Fracture Reduction. IEEE Robot Autom Lett 2022. [DOI: 10.1109/lra.2022.3150880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
15
|
Experimental and finite element analysis studies of a reduction-force reducing traction method for pelvic fracture surgeries. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2022. [DOI: 10.1016/j.medntd.2021.100101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
16
|
Rowson B. 2021 Athanasiou Student and Post-Doc Awards. Ann Biomed Eng 2022; 50:235-236. [DOI: 10.1007/s10439-022-02916-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/01/2022] [Indexed: 11/01/2022]
|
17
|
3D Printing Adjustable Stiffness External Fixator for Mechanically Stimulated Healing of Tibial Fractures. BIOMED RESEARCH INTERNATIONAL 2022; 2021:8539416. [PMID: 34977247 PMCID: PMC8718297 DOI: 10.1155/2021/8539416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/06/2021] [Indexed: 11/17/2022]
Abstract
External fixation is a long-standing but well-established method, which has been widely used for the treatment of fractures. To obtain the maximum benefit from the mechanical stimulus, the stiffness of the external fixator should be adjusted properly throughout the treatment phase. Nevertheless, the lack of a valid dynamic adjustable fixation device impedes this possibility. Based on the stiffness adjustment tolerance of the healing callus, this paper proposes an active-dynamic stiffness adjustable external fixator design method to meet stiffness requirements at different stages of the tibial fracture healing process. A novel external fixator with an adjustable stiffness configuration was designed, and the finite element method was used to simulate the stress distribution between fixator and fracture gap. The stiffness adjustment tolerance was determined based on previous studies. According to this tolerance, the optimal block structure dismantling sequence was sought and the corresponding stiffness was calculated through topology optimization for the entire external fixator model. The appropriate amount of variable stiffness at the fracture gap was applied by dismantling the configuration of the block structure external fixator during the healing process. A novel patient-specific adjustable stiffness external fixator for mechanically stimulated tibial fracture reduction and therapy was proposed. This enables surgeons to tailor the construction of the external fixator frame to the clinical needs of each patient. The presented dismantling approach of the block structure to produce conformable stiffness provides a new clinical treatment strategy for tibial fractures.
Collapse
|
18
|
Xu H, Lei J, Hu L, Zhang L. Constraint of musculoskeletal tissue and path planning of robot-assisted fracture reduction with collision avoidance. Int J Med Robot 2021; 18:e2361. [PMID: 34969160 DOI: 10.1002/rcs.2361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 12/27/2021] [Accepted: 12/28/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND For the robot-assisted fracture reduction, due to the complex fracture musculoskeletal environment, it is necessary to consider the influence of soft tissue traction on preoperative reduction path planning. METHOD An improved 3D A* algorithm is adopted to plan the fracture reduction path. The distal fragment point clouds are updated to avoid the collision, and the end point coordinates of the muscles are updated to calculate muscular lengths during the path search. RESULTS 3D reduction path of long-bone fracture is planned, effectively avoiding the fracture fragments collision and ensuring the length of the corresponding muscle is always less than the allowable maximum muscle length after elongation. CONCLUSION The proposed method can effectively avoid the collision between the distal fragment and the proximal fragment during the fracture reduction, can avoid secondary injury of the muscles around the femoral bone caused by over-distraction, and effectively improve the safety of robot reduction operation. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Haifei Xu
- School of Mechatronic Engineering and Automation, Shanghai University, Shanghai, China
| | - Jingtao Lei
- School of Mechatronic Engineering and Automation, Shanghai University, Shanghai, China
| | - Lei Hu
- School of Mechanical Engineering and Automation, Beihang University, Beijing, China
| | - Lihai Zhang
- Department of Orthopaedics, Chinese PLA General Hospital, Beijing, China
| |
Collapse
|
19
|
A Marker-Free 2D Image-Guided Method for Robot-Assisted Fracture Reduction Surgery. J INTELL ROBOT SYST 2021. [DOI: 10.1007/s10846-021-01453-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
20
|
Min Z, Liu J, Liu L, Meng MQH. Generalized Coherent Point Drift With Multi-Variate Gaussian Distribution and Watson Distribution. IEEE Robot Autom Lett 2021. [DOI: 10.1109/lra.2021.3093011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
21
|
Cai C, Sun C, Song Y, Lv Q, Bi J, Zhang Q. Bone collision detection method for robot assisted fracture reduction based on force curve slope. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 209:106315. [PMID: 34352651 DOI: 10.1016/j.cmpb.2021.106315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/21/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND OBJECTIVE The application of robot technology in fracture reduction ensures the minimal invasiveness and accurate operation process. Most of the existing robot assisted fracture reduction systems don't have the function of bone collision detection, which is very important for system safety. In view of the deficiencies in the research of this field, a broken bone collision detection method based on the slope ratio of force curve was proposed in this paper, which could realize the real-time detection. METHODS In order to analyze the factors influencing the slope of force curve, a collision mechanical model based on three-element viscoelastic model was established. The effects of four factors on the slope ratio of the force curve were studied based on the mechanical model. The proposed collision detection model was analyzed in detail. By drawing slope ratio curves under various experimental conditions, the universality of the collision detection model was proved; by comparative simulation, the differences between the slope ratio curves before and after optimization were analyzed. The factors that affect the performance of the detection model were also analyzed. RESULTS The results of collision experiments show that the increase of moving speed of distal bone and soft tissue mass reduces the slope ratio, while the increase of collision angle increases the slope ratio. In the verification experiment, the minimum main peak of KRopt curve is 14.16 and the maximum is 220.7, the maximum interference value before the peak is 6.1. When the detection threshold is 10, the model can detect the collision state of the broken bone. It is also proved that after optimization, the model can effectively filter out invalid waveforms and reduce the occurrence of false detections. When a=5 and b=40, the detection model has sufficient stability and a low detection time delay. CONCLUSION This research developed a broken bone collision detection method based on the slope ratio of the force curve. After optimization, the method has good adaptability under a variety of experimental conditions. The collision of broken bones can be judged by setting an appropriate detection threshold. The application of this method in the robot fracture reduction system will improve the safety of the system.
Collapse
Affiliation(s)
- Chenxu Cai
- Key Laboratory of High Efficiency and Clean Mechanical Manufacture (Ministry of Education), School of Mechanical Engineering, Shandong University, Jinan 250061, China; National Demonstration Center for Experimental Mechanical Engineering Education, Shandong University, Jinan 250061, China
| | - Congyu Sun
- Key Laboratory of High Efficiency and Clean Mechanical Manufacture (Ministry of Education), School of Mechanical Engineering, Shandong University, Jinan 250061, China; National Demonstration Center for Experimental Mechanical Engineering Education, Shandong University, Jinan 250061, China
| | - Yixuan Song
- Key Laboratory of High Efficiency and Clean Mechanical Manufacture (Ministry of Education), School of Mechanical Engineering, Shandong University, Jinan 250061, China; National Demonstration Center for Experimental Mechanical Engineering Education, Shandong University, Jinan 250061, China
| | - Qinjing Lv
- Key Laboratory of High Efficiency and Clean Mechanical Manufacture (Ministry of Education), School of Mechanical Engineering, Shandong University, Jinan 250061, China; National Demonstration Center for Experimental Mechanical Engineering Education, Shandong University, Jinan 250061, China
| | - Jianping Bi
- The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, China
| | - Qinhe Zhang
- Key Laboratory of High Efficiency and Clean Mechanical Manufacture (Ministry of Education), School of Mechanical Engineering, Shandong University, Jinan 250061, China; National Demonstration Center for Experimental Mechanical Engineering Education, Shandong University, Jinan 250061, China.
| |
Collapse
|
22
|
Li G, Li J, Zuo S, Dong M. Influence of parameter deviation on the closeness of the tibial limb and external fixator based on a novel collision detection algorithm. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2021; 37:e3502. [PMID: 34114336 DOI: 10.1002/cnm.3502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/21/2021] [Accepted: 06/04/2021] [Indexed: 06/12/2023]
Abstract
The Ortho-SUV frame (OSF) is a hexapod external fixator widely applied in orthopedics deformity correction. The possibility of collision between OSF's struts and the soft tissue is an essential but overlooked issue. To avoid the issue, a novel collision detection algorithm is established based on a cone-cylinder model of the tibial limb-strut interaction for detecting the closeness of the tibial limb and external fixator. The algorithm is constructed using the vector analysis based on the model of the minimum distance between the truncated cone generatrix and the cylinder axis. The motion simulation is performed on the overall alignment through the Solidworks-motion module to verify the feasibility of the algorithm. Subsequently, the installation parameter deviations of the bone-fixator system are described to investigate the influence of orientation and position deviation on the closeness of the tibial limb and external fixator through the numerical method. The investigation results show that the orientation deviation γ (around the z-axis), the position deviation τ1 and τ2 (along the x and y-axes, respectively) have greater sensitivity to closeness and the influence of multiple deviations on the closeness has the property of superposition. The proposed algorithm can assist clinicians to strictly design and appraise frame configurations prior to their application to avoid the collision between the external fixator and the limbs during the correction. It has great application significance in the development of computer-aided correction software.
Collapse
Affiliation(s)
- Guotong Li
- Beijing Key Laboratory of Advanced Manufacturing Technology, Faculty of Materials and Manufacturing, Beijing University of Technology, Beijing, PR China
| | - Jianfeng Li
- Beijing Key Laboratory of Advanced Manufacturing Technology, Faculty of Materials and Manufacturing, Beijing University of Technology, Beijing, PR China
| | - Shiping Zuo
- Beijing Key Laboratory of Advanced Manufacturing Technology, Faculty of Materials and Manufacturing, Beijing University of Technology, Beijing, PR China
| | - Mingjie Dong
- Beijing Key Laboratory of Advanced Manufacturing Technology, Faculty of Materials and Manufacturing, Beijing University of Technology, Beijing, PR China
| |
Collapse
|
23
|
Wu J, Zhou P, Zhang Y, Xiao L, Li L, Xu S. A new technology using a customized 3D printed fixator to assist fracture reduction and fixation: Technical note. Int J Med Robot 2021; 17:e2270. [PMID: 33908164 DOI: 10.1002/rcs.2270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/18/2021] [Accepted: 04/26/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Poor reduction can lead to complications such as deformity and delayed fracture healing. We introduce a 3D printed external fixator technology that can assist in fracture reduction and fixation. METHODS A fractured long bone was first fixed by a temporary external fixator and then scanned with computed tomography. Three-dimensional reconstruction of the contour and bone fragments of the affected limb was performed using Mimics software, and the fracture reduction was simulated. Subsequently, data were imported into SolidWorks software for customized external fixator design and 3D printing. Through the precise assembly of the 3D printed external fixator and external fixation pins, automatic fracture reduction. RESULTS The patient's fractures were well reduced, firmly fixed, and the postoperative fractures healed well with no complications. CONCLUSION The technique we introduce not only assists in fracture reduction for temporary external fixation but can also be used as a definitive treatment for long bone fractures.
Collapse
Affiliation(s)
- Jianghong Wu
- Department of Emergency, Changhai Hospital, Second Military Medical University (Naval Medical University), Shanghai, China.,Department of Orthopedics, Changhai Hospital, Second Military Medical University (Naval Medical University), Shanghai, China
| | - Panyu Zhou
- Department of Emergency, Changhai Hospital, Second Military Medical University (Naval Medical University), Shanghai, China.,Department of Orthopedics, Changhai Hospital, Second Military Medical University (Naval Medical University), Shanghai, China
| | - Yuntong Zhang
- Department of Emergency, Changhai Hospital, Second Military Medical University (Naval Medical University), Shanghai, China.,Department of Orthopedics, Changhai Hospital, Second Military Medical University (Naval Medical University), Shanghai, China
| | - Liang Xiao
- Department of Naval Environment and Labor Hygiene, Faculty of Naval Medicine, Second Military Medical University (Naval Medical University), Shanghai, China
| | - Lei Li
- Department of Emergency, Changhai Hospital, Second Military Medical University (Naval Medical University), Shanghai, China.,Department of Orthopedics, Changhai Hospital, Second Military Medical University (Naval Medical University), Shanghai, China
| | - Shuogui Xu
- Department of Emergency, Changhai Hospital, Second Military Medical University (Naval Medical University), Shanghai, China.,Department of Orthopedics, Changhai Hospital, Second Military Medical University (Naval Medical University), Shanghai, China
| |
Collapse
|
24
|
Annals of Biomedical Engineering 2020 Year in Review. Ann Biomed Eng 2021. [DOI: 10.1007/s10439-021-02738-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
25
|
Duan X, Tian H, Li C, Han Z, Cui T, Shi Q, Wen H, Wang J. Virtual-Fixture Based Drilling Control for Robot-Assisted Craniotomy: Learning From Demonstration. IEEE Robot Autom Lett 2021. [DOI: 10.1109/lra.2021.3061388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
26
|
Javaid M, Haleem A, Vaish A, Vaishya R, Iyengar KP. Robotics Applications in COVID-19: A Review. JOURNAL OF INDUSTRIAL INTEGRATION AND MANAGEMENT-INNOVATION AND ENTREPRENEURSHIP 2020. [DOI: 10.1142/s2424862220300033] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The COVID-19 outbreak has resulted in the manufacturing and service sectors being badly hit globally. Since there are no vaccines or any proven medical treatment available, there is an urgent need to take necessary steps to prevent the spread of this virus. As the virus spreads with human-to-human interaction, lockdown has been declared in many countries, and the public is advised to observe social distancing strictly. Robots can undertake human-like activities and can be gainfully programmed to replace some of the human interactions. Through this paper, we identify and propose the introduction of robots to take up this challenge in the fight against the COVID-19 pandemic. We did a comprehensive review of the literature to identify robots’ possible applications in the management of epidemics and pandemics of this nature. We have reviewed the available literature through the search engines of PubMed, SCOPUS, Google Scholar, and Research Gate. A comprehensive review of the literature identified different types of robots being used in the medical field. We could find several vital applications of robots in the management of the COVID-19 pandemic. No doubt technology comes with a cost. In this paper, we identified how different types of robots are used gainfully to deliver medicine, food, and other essential items to COVID-19 patients who are under quarantine. Therefore, there is extensive scope for customising robots to undertake hazardous and repetitive jobs with precision and reliability.
Collapse
Affiliation(s)
- Mohd Javaid
- Department of Mechanical Engineering, Jamia Millia Islamia, New Delhi, India
| | - Abid Haleem
- Department of Mechanical Engineering, Jamia Millia Islamia, New Delhi, India
| | - Abhishek Vaish
- Department of Orthopaedics, Indraprastha Apollo Hospital, SaritaVihar, Mathura Road, 110076, New Delhi, India
| | - Raju Vaishya
- Department of Orthopaedics, Indraprastha Apollo Hospital, SaritaVihar, Mathura Road, 110076, New Delhi, India
| | - Karthikeyan P Iyengar
- FRCS (Tr & Orth), Trauma and Orthopaedic Surgeon, Southport and ORMSKIRK NHS Trust, Southport, UK, PR8 6 PN, UK
| |
Collapse
|
27
|
[Economic aspects of digitalization in orthopedics and trauma surgery]. Unfallchirurg 2020; 123:856-861. [PMID: 33079219 PMCID: PMC7574668 DOI: 10.1007/s00113-020-00891-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Einleitung Das Fortschreiten der Digitalisierung wird neben Vorteilen für Patienten und Ärzte auch ökonomische Implikationen für das Gesundheitswesen in toto weltweit haben. Die Integration digitaler Innovationen ermöglicht es Gesundheitsunternehmen, ihre bisherigen Aktivitäten und Prozesse zu transformieren und eine neue Form der Patientenversorgung zu schaffen. Wichtige ökonomische Themenfelder der Digitalisierung Mithilfe digitaler Anwendungen können eine Prozessoptimierung durch Effizienzsteigerung und damit eine Kostensenkung im Gesundheitswesen erreicht werden. Verbesserte Prozesse können wiederum eine Qualitätssteigerung bei der Behandlung von Patienten erreichen. Gleichzeitig kann durch digitale Schnittstellen eine Doppelung von Untersuchungen vermieden und die Kommunikation unter beteiligten Gesundheitsprofessionen verbessert werden, was eine Ressourcenschonung zur Folge hätte. Letztlich können diese Einflüsse zu einer Präzisierung der Medizin führen, Heilungsabläufe beschleunigen und für alle Beteiligten einen Vorteil darstellen. Ausblick Ökonomische Umverteilungen durch die Digitalisierung der Medizin werden sich erst in der Zukunft klar zeigen. Ethische Überlegungen und auch der Datenschutz werden wichtige Themen sein. Gleichzeitig müssen Investitionen und digitale Innovationen von staatlicher und unternehmerischer Seite gefördert werden. Wissenschaftliche Studien können auch in der Orthopädie und Unfallchirurgie helfen, die nötige Evidenz neuer Methoden für die Praxis zu sichern.
Collapse
|
28
|
Abstract
BACKGROUND Numerous processes are involved in the orthopedic and trauma surgery operating room (OR). Technical progress, particularly in the area of digitalization, is increasingly changing routine surgical procedures. OBJECTIVE This article highlights the possibilities and also limitations regarding this matter. MATERIAL AND METHODS Based on the current literature this article provides insights into innovations in the areas of digitalization of surgical devices, hybrid OR, machine-2-machine networking, management systems for perioperative efficiency improvement, 3D printing technology and robotics. RESULTS The technical possibilities for the use of digital applications in the surgical environment are rapidly increasing. Close cooperation with industrial partners is important in this context. Technologies from the automotive, gaming and mobile phone industries are being adopted. CONCLUSION Digital technology in the OR can improve treatment quality, patient and staff safety and cost efficiency; however, the networking of devices, implementation of innovations in existing structures and the sometimes high acquisition costs are still limiting factors.
Collapse
Affiliation(s)
- B Swartman
- Klinik für Unfallchirurgie und Orthopädie, BG Klinik Ludwigshafen, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Deutschland.
| | - J Franke
- Klinik für Unfallchirurgie und Orthopädie, BG Klinik Ludwigshafen, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Deutschland
| | - C Schnurr
- Klinik für Orthopädie, St. Vinzenz Krankenhaus, Verbund Katholischer Kliniken Düsseldorf, Amalienstr. 9, 40472, Düsseldorf, Deutschland
| | - S Märdian
- Centrum für Muskuloskeletale Chirurgie, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland
| | - C Willy
- Klinik für Unfallchirurgie und Orthopädie, Bundeswehrkrankenhaus Berlin, Berlin, Deutschland
| | | | | | - D A Back
- Klinik für Unfallchirurgie und Orthopädie, Bundeswehrkrankenhaus Berlin, Berlin, Deutschland
| |
Collapse
|
29
|
Abstract
The increasing digitalization of social life opens up new possibilities for modern health care. This article describes innovative application possibilities that could help to sustainably improve the treatment of severe injuries in the future with the help of methods such as big data, artificial intelligence, intelligence augmentation, and machine learning. For the successful application of these methods, suitable data sources must be available. The TraumaRegister DGU® (TR-DGU) currently represents the largest database in Germany in the field of care for severely injured patients that could potentially be used for digital innovations. In this context, it is a good example of the problem areas such as data transfer, interoperability, standardization of data sets, parameter definitions, and ensuring data protection, which still represent major challenges for the digitization of trauma care. In addition to the further development of new analysis methods, solutions must also continue to be sought to the question of how best to intelligently link the relevant data from the various data sources.
Collapse
|
30
|
Luo J, Yan YJ, Wang XD, Long XD, Lan H, Li KN. Accuracy and Safety of Robot-Assisted Drilling Decompression for Osteonecrosis of the Femoral Head. Orthop Surg 2020; 12:784-791. [PMID: 32394643 PMCID: PMC7307221 DOI: 10.1111/os.12678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 03/14/2020] [Accepted: 03/18/2020] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE To investigate the safety and superiority of robot-assisted femoral head drilling decompression in the treatment of femoral head necrosis. METHODS A total of 63 patients who underwent borehole decompression of the femoral head in our hospital from January 2016 to March 2019 were recruited. Patients were divided into two groups for comparison according to surgical methods. In the robot-assisted surgery group, there were 30 cases with 41 femoral heads. The conventional group had 33 cases and 46 femoral heads. All patients signed the consent form before the operation. The follow-up time was 6 months. The incision lengths, operation times, intraoperative blood loss, intraoperative fluoroscopies, guide needle punctures, postoperative Harris scores, and postoperative complications of the two groups were compared. RESULTS The incision length of the robot surgery group was 5.16 ± 0.41 cm, while that of the traditional surgery group was 7.42 ± 0.50 cm. The operation time of the robot surgery group was 46.99 ± 4.94 min, while that of the traditional surgery group was 55.01 ± 6.19 min. The fluoroscopy frequency of the robot surgery group was 10.50 ± 1.78 times, while that of the traditional surgery group was 17.91 ± 2.20 times. The intraoperative blood loss in the robotic surgery group was 20.62 ± 2.52 mL, while that in the conventional surgery group was 52.72 ± 3.39 mL. In the robot operation group, each femoral head guide needle was punctured three times, and the puncture was successful one time. The number of guided needle punctures in the traditional group was 8.02 ± 1.73. The difference between the two groups was statistically significant (P < 0.05). The Harris score was 69.53 ± 7.51 in the robot surgery group and 68.38 ± 7.26 in the traditional surgery group one month after surgery, 78.52 ± 6.49 in the robot surgery group and 76.41 ± 7.95 in the traditional surgery group three months after surgery, and 83.32 ± 8.62 in the robot surgery group and 81.74 ± 6.20 in the traditional surgery group six months after surgery. There was no significant difference between the two groups (P > 0.05). In the traditional group, there was one case of incision infection and one case of femoral head collapse during follow-up. In the robot group, there were no complications, such as incision infection and deep vein thrombosis. No collapse of the femoral head was found in the robot group during follow-up. CONCLUSION The positioning system of the orthopaedic robot is an ideal method for the treatment of femoral head necrosis. This method has the advantages of simple operation, accurate drilling, a short operation time, less surgical trauma, less radioactivity, and good recovery of hip joint function.
Collapse
Affiliation(s)
- Jin Luo
- Department of Orthopaedics, Affiliated Hospital of Chengdu University, Chengdu, China
| | - Ya-Jing Yan
- Department of Orthopaedics, Affiliated Hospital of Chengdu University, Chengdu, China
| | - Xiao-Dong Wang
- Department of Orthopaedics, Affiliated Hospital of Chengdu University, Chengdu, China
| | - Xu-Dong Long
- Department of Orthopaedics, Affiliated Hospital of Chengdu University, Chengdu, China
| | - Hai Lan
- Department of Orthopaedics, Affiliated Hospital of Chengdu University, Chengdu, China
| | - Kai-Nan Li
- Department of Orthopaedics, Affiliated Hospital of Chengdu University, Chengdu, China
| |
Collapse
|
31
|
Mois G, Beer JM. The Role of Healthcare Robotics in Providing Support to Older Adults: a Socio-ecological Perspective. CURRENT GERIATRICS REPORTS 2020; 9:82-89. [PMID: 32435576 PMCID: PMC7223616 DOI: 10.1007/s13670-020-00314-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE OF REVIEW In this review, we provide an overview of how healthcare robotics can facilitate healthy aging, with an emphasis on physical, cognitive, and social supports. We next provide a synthesis of future challenges and considerations in the development and application of healthcare robots. We organize these considerations using a socio-ecological perspective and discuss considerations at the individual, care partner, community healthcare, and healthcare policy levels. RECENT FINDINGS Older adults are the fastest growing segment of the US population. Age-related changes and challenges can present difficulties, for older adults want to age healthily and maintain independence. Technology, specifically healthcare robots, has potential to provide health supports to older adults. These supports span widely across the physical, cognitive, and social aspects of healthy aging. SUMMARY Our review suggests that while healthcare robotics has potential to revolutionize the way in which older adults manage their health, there are many challenges such as clinical effectiveness, technology acceptance, health informatics, and healthcare policy and ethics. Addressing these challenges at all levels of the healthcare system will help ensure that healthcare robotics promote healthy aging and are applied safely, effectively, and reliably.
Collapse
Affiliation(s)
- George Mois
- School of Social Work, University of Georgia, 279 Williams St, Athens, GA 30602 USA
| | - Jenay M. Beer
- School of Social Work, University of Georgia, 279 Williams St, Athens, GA 30602 USA
- Institute of Gerontology, University of Georgia, 102 Spear Road, Athens, GA 30606 USA
| |
Collapse
|
32
|
Zhao JX, Su XY, Zhao Z, Xiao RX, Zhang LC, Tang PF. Radiographic assessment of the cup orientation after total hip arthroplasty: a literature review. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:130. [PMID: 32175423 DOI: 10.21037/atm.2019.12.150] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Optimal acetabular cup orientation is of substantial importance to good long-term function and low complication rates after total hip arthroplasty (THA). The radiographic anteversion (RA) and inclination (RI) angles of the cup are typically studied due to the practicability, simplicity, and ease of interpretation of their measurements. A great number of methods have been developed to date, most of which have been performed on pelvic or hip anteroposterior radiographs. However, there are primarily two influencing factors for these methods: X-ray offset and pelvic rotation. In addition, there are three types of pelvic rotations about the transverse, longitudinal, and anteroposterior axes of the body. Their effects on the RA and RI angles of the cup are interactively correlated with the position and true orientation of the cup. To date, various fitted or analytical models have been established to disclose the correlations between the X-ray offset and pelvic rotation and the RA and RI angles of the cup. Most of these models do not incorporate all the potential influencing parameters. Advanced methods for performing X-ray offset and pelvic rotation corrections are mainly performed on a single pelvic AP radiograph, two synchronized radiographs, or a two-dimensional/three-dimensional (2D-3D) registration system. Some measurement systems, originally developed for evaluating implant migration or wear, could also be used for correcting the X-ray offset and pelvic rotation simultaneously, but some drawbacks still exist with these systems. Above all, the 2D-3D registration technique might be an alternative and powerful tool for accurately measuring cup orientation. In addition to the current methods used for postoperative assessment, navigation systems and augmented reality are also used for the preoperative planning and intraoperative guidance of cup placement. With the continuing development of artificial intelligence and machine learning, these techniques could be incorporated into robot-assisted orthopaedic surgery in the future.
Collapse
Affiliation(s)
- Jing-Xin Zhao
- Department of Orthopaedics, the First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China.,National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing 100853, China
| | - Xiu-Yun Su
- Department of Orthopaedics, the First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China.,Intelligent and Digital Surgery Innovation Center, Southern University of Science and Technology Hospital, Shenzhen, Guangdong 518055, China
| | - Zhe Zhao
- Department of Orthopaedics, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
| | - Ruo-Xiu Xiao
- School of Computer and Communication Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Li-Cheng Zhang
- Department of Orthopaedics, the First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China.,National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing 100853, China
| | - Pei-Fu Tang
- Department of Orthopaedics, the First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China.,National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing 100853, China
| |
Collapse
|
33
|
Abstract
Artificial intelligence (AI) is a very relevant topic for the medicine of the future. This article focuses on the field of AI in the context of orthopedics and trauma surgery. The main focus is on the potentials of AI in the analysis of symptoms, radiological images, clinical data sets, use in hospitals and operating theaters as well as for training and education. For the orthopedics and trauma surgery of the future AI is much more than pure fiction; however, there is still a long way to go before the potential of an optimized and individualized patient care can be utilized. Interdisciplinary and international approaches, including personnel, economic, legal and ethical aspects will play a decisive role in this respect.
Collapse
|
34
|
Recent Trends, Technical Concepts and Components of Computer-Assisted Orthopedic Surgery Systems: A Comprehensive Review. SENSORS 2019; 19:s19235199. [PMID: 31783631 PMCID: PMC6929084 DOI: 10.3390/s19235199] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 11/08/2019] [Accepted: 11/12/2019] [Indexed: 12/17/2022]
Abstract
Computer-assisted orthopedic surgery (CAOS) systems have become one of the most important and challenging types of system in clinical orthopedics, as they enable precise treatment of musculoskeletal diseases, employing modern clinical navigation systems and surgical tools. This paper brings a comprehensive review of recent trends and possibilities of CAOS systems. There are three types of the surgical planning systems, including: systems based on the volumetric images (computer tomography (CT), magnetic resonance imaging (MRI) or ultrasound images), further systems utilize either 2D or 3D fluoroscopic images, and the last one utilizes the kinetic information about the joints and morphological information about the target bones. This complex review is focused on three fundamental aspects of CAOS systems: their essential components, types of CAOS systems, and mechanical tools used in CAOS systems. In this review, we also outline the possibilities for using ultrasound computer-assisted orthopedic surgery (UCAOS) systems as an alternative to conventionally used CAOS systems.
Collapse
|
35
|
Mont MA, Krebs VE, Backstein DJ, Browne JA, Mason JB, Taunton MJ, Callaghan JJ. Artificial Intelligence: Influencing Our Lives in Joint Arthroplasty. J Arthroplasty 2019; 34:2199-2200. [PMID: 31445865 DOI: 10.1016/j.arth.2019.08.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
|