Klinisches Outcome nach Roboter-assistierter versus konventionell implantierter Hüftendoprothetik: Prospektive, kontrollierte Untersuchung von 71 Patienten

Siebel, Thomas; Käfer, Wolfram

doi:10.1055/s-2005-836776

Cited by 53 publications

(20 citation statements)

References 18 publications

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“…The same study 12 reported that two patients who underwent robotic-assisted THA (6%) and one who underwent conventional THA (3%) required revision surgery. None of the patients in any other studies, however, required revision.…”

Section: Surgical Aspectsmentioning

confidence: 79%

“…For example, rates of thigh pain after 1, 3 and 12 months were similar in patients who underwent robotic-assisted and those who underwent conventional THA. 9 10 Although one study 12 found that the rate of Trendelenburg signs was significantly higher in the robotic-assisted than in the conventional THA group (61% vs 26%, p=0.0014), this outcome was not measured in the other six included studies.…”

Section: Surgical Aspectsmentioning

confidence: 96%

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Robotic-assisted compared with conventional total hip arthroplasty: systematic review and meta-analysis

Chen

Xiong

Wang

et al. 2018

Postgraduate Medical Journal

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BackgroundRobotic-assisted total hip arthroplasty (THA) allows for accurate preoperative planning and component positioning, potentially enhancing implant survival and long-term outcomes. The relative efficacy and safety of robotic-assisted and conventional THA, however, are unclear. This systematic review and meta-analysis compared the safety and efficacy of robotic-assisted and conventional THA.MethodsMedline, Embase and the Cochrane Library were comprehensively searched in September 2017 to identify studies comparing the safety and efficacy of robotic-assisted and conventional THA. Seven studies were included. Data of interest were extracted and analysed using Review Manager 5.3.ResultsThe seven included studies involved 1516 patients, with 522 undergoing robotic-assisted and 994 undergoing conventional THA. Compared with conventional THA, robotic-assisted THA was associated with longer surgical time (not significant); lower intraoperative complication rates (OR: 0.12, 95% CI: 0.05 to 0.34, p<0.0001 I2); better cup placement, stem placement and global offset and a higher rate of heterotopic ossifications. Functional scores, limb length discrepancy and rates of revision and stress shielding were similar in the two groups. The relative amount of blood loss was unclear.ConclusionThe results of this meta-analysis suggest that robotic-assisted THA has certain advantages over conventional THA, including the results of component positioning and rates of intraoperative complications. Additional comparative studies are required to determine the long-term clinical outcomes of robotic-assisted THA.

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Section: Surgical Aspectsmentioning

confidence: 79%

Section: Surgical Aspectsmentioning

confidence: 96%

Robotic-assisted compared with conventional total hip arthroplasty: systematic review and meta-analysis

Chen

Xiong

Wang

et al. 2018

Postgraduate Medical Journal

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“…Overall complications were compared in nine RCT [25, 26, 28–30, 76, 106–108] and 28 prospective [16, 17, 19, 20, 32, 34–37, 39, 41, 43, 45–47, 49, 68–70, 94–96, 109–113] studies. From these studies, the overall complication rate was 11.6 % (515/4453) in the robotic arm compared with 21.4 % (693/3245) in the open arm.…”

Section: Resultsmentioning

confidence: 99%

“…Analysis of the 76 prospective studies revealed that just 47 [16–20, 23, 31–37, 39, 41, 43, 47, 49, 55, 57, 59, 61, 64, 65, 67–71, 75, 85, 86, 88, 89, 91, 94–96, 101, 111–113] of them (61.8 %) had adequate power for outcome evaluation, assuming large effect sizes. For medium effect sizes, 20 studies [31–33, 35–37, 41, 43, 59, 61, 67–70, 75, 85, 86, 95, 111, 112] (26·3 %) were sufficiently powered.…”

Section: Resultsmentioning

confidence: 99%

Robotic surgery: disruptive innovation or unfulfilled promise? A systematic review and meta-analysis of the first 30 years

et al. 2016

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BackgroundRobotic surgery has been in existence for 30 years. This study aimed to evaluate the overall perioperative outcomes of robotic surgery compared with open surgery (OS) and conventional minimally invasive surgery (MIS) across various surgical procedures.MethodsMEDLINE, EMBASE, PsycINFO, and ClinicalTrials.gov were searched from 1990 up to October 2013 with no language restriction. Relevant review articles were hand-searched for remaining studies. Randomised controlled trials (RCTs) and prospective comparative studies (PROs) on perioperative outcomes, regardless of patient age and sex, were included. Primary outcomes were blood loss, blood transfusion rate, operative time, length of hospital stay, and 30-day overall complication rate.ResultsWe identified 99 relevant articles (108 studies, 14,448 patients). For robotic versus OS, 50 studies (11 RCTs, 39 PROs) demonstrated reduction in blood loss [ratio of means (RoM) 0.505, 95 % confidence interval (CI) 0.408–0.602], transfusion rate [risk ratio (RR) 0.272, 95 % CI 0.165–0.449], length of hospital stay (RoM 0.695, 0.615–0.774), and 30-day overall complication rate (RR 0.637, 0.483–0.838) in favour of robotic surgery. For robotic versus MIS, 58 studies (21 RCTs, 37 PROs) demonstrated reduced blood loss (RoM 0.853, 0.736–0.969) and transfusion rate (RR 0.621, 0.390–0.988) in favour of robotic surgery but similar length of hospital stay (RoM 0.982, 0.936–1.027) and 30-day overall complication rate (RR 0.988, 0.822–1.188). In both comparisons, robotic surgery prolonged operative time (OS: RoM 1.073, 1.022–1.124; MIS: RoM 1.135, 1.096–1.173). The benefits of robotic surgery lacked robustness on RCT-sensitivity analyses. However, many studies, including the relatively few available RCTs, suffered from high risk of bias and inadequate statistical power.ConclusionsOur results showed that robotic surgery contributed positively to some perioperative outcomes but longer operative times remained a shortcoming. Better quality evidence is needed to guide surgical decision making regarding the precise clinical targets of this innovation in the next generation of its use.

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“…Other surgical complications they reported were insertion of the cup at a suboptimal angle needing revision, femoral fissuring during repositioning and excess blood loss. Siebel and Käfer using the CASPAR system for hip arthroplasty reported a higher surgical time and an increased incidence of poor post op hip abductor function and incidence of Trendelenburg’s sign [33]. Similar technical and surgical complications have been reported with knee arthroplasty where procedures had to be abandoned due to failure of registration, robot workspace issues and damage to the patellar tendon [34, 35].…”

Section: Evidence For Robotsmentioning

confidence: 94%

Evidence for robots

Shenoy

Nathwani

2017

SICOT-J

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Robots have been successfully used in commercial industry and have enabled humans to perform tasks which are repetitive, dangerous and requiring extreme force. Their role has evolved and now includes many aspects of surgery to improve safety and precision. Orthopaedic surgery is largely performed on bones which are rigid immobile structures which can easily be performed by robots with great precision. Robots have been designed for use in orthopaedic surgery including joint arthroplasty and spine surgery. Experimental studies have been published evaluating the role of robots in arthroscopy and trauma surgery. In this article, we will review the incorporation of robots in orthopaedic surgery looking into the evidence in their use.

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Klinisches Outcome nach Roboter-assistierter versus konventionell implantierter Hüftendoprothetik: Prospektive, kontrollierte Untersuchung von 71 Patienten

Abstract: The significant functional impairment following robotic assisted THA should be taken critically into consideration prior to initiating such procedure.

Cited by 53 publications

References 18 publications

Robotic-assisted compared with conventional total hip arthroplasty: systematic review and meta-analysis

Robotic-assisted compared with conventional total hip arthroplasty: systematic review and meta-analysis

Robotic surgery: disruptive innovation or unfulfilled promise? A systematic review and meta-analysis of the first 30 years

Evidence for robots

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