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Objective: To assess if incorporation of DRS sensing into real-time robotic surgery systems has merit. DRS as a technology is relatively simple, cost-effective and provides a non-contact approach to tissue differentiation. Methods: Supervised machine learning analysis of diffuse reflectance spectra was performed to classify human joint tissue that was collected from surgical procedures. Results: We have used supervised machine learning in the classification of a DRS human joint tissue data set and achieved classification accuracy in excess of 99%. Sensitivity for the various classes were; cartilage 99.7%, subchondral 99.2%, meniscus 100% and cancellous 100%. Full wavelength range is required for maximum classification accuracy. The wavelength resolution must be larger than 8nm. A SNR better than 10:1 was required to achieve a classification accuracy greater than 50%. The 800-900nm wavelength range gave the greatest accuracy amongst those investigated Conclusion: DRS is a viable method for differentiating human joint tissue and has the potential to be incorporated into robotic orthopaedic surgery.

Purpose/Background: Olecranon fractures are common, particularly in the elderly osteoporotic population. Although various techniques of fixation are available, the gold standard—tension band wiring (TBW)—has high complication and reoperation rates. We sought to identify current evidence for the use of high-strength suture tension banding methods to determine whether they reduce complications and reoperation rates while maintaining fixation. Methods: A systematic review of several databases was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases included Cochrane, PubMed, MEDLINE and Embase. We searched for evidence of at least Level I to IV (according to NHMRC) of the use of tension band suturing or anchors in the surgical treatment of displaced olecranon fractures. We also analyzed the cost of fixation in our institute. Results: Four hundred and forty articles were identified. Of these, 9 met the inclusion criteria. One hundred thirty-one subjects had an average age of 66 years. All the studies showed that high-strength suture tension banding/anchoring maintained fixation with displaced olecranon fractures, reducing the complication rates and showed minimal reoperation rates. There was also a significant cost advantage of the suture tape construct mainly due to avoiding subsequent removal of metal. Conclusion: Tension band suturing or anchoring displaced olecranon fractures may be an alternative cost effective method to TBW in maintaining fixation, reducing metalware complications and reducing re-operation rates. Level of Evidence: IV.