Robot-assisted vs freehand cannulated screw placement in femoral neck fractures surgery

Zheng, Yongshun; Yang, Jiazhao; Zhang, Fan; Lu, Jinsen; Qian, Yeben

doi:10.1097/md.0000000000025926

Cited by 4 publications

(2 citation statements)

References 44 publications

(155 reference statements)

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“…The reason for this is that the surgical guiding template needs to be personalized based on the patient's preoperative imaging, and the preparation process is tedious and time-consuming [29][30][31]. Image-guided navigation-based techniques can improve the accuracy of orthopedic surgery [32,33]. However, the application of navigation techniques in patellar fracture surgery has not been reported in the literature.…”

Section: Guiding Devices and Their Clinical Applicationmentioning

confidence: 99%

Progress on Kirschner wire insertion techniques for patellar fractures

2023

PMD

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Tension band wiring has been widely used in patellar fracture internal fixation. However, Kirschner wires (K-wires) insertion is time-consuming, because it requires multiple intraoperative fluoroscopies to adjust the insertion angle, and the accuracy of insertion is not ideal. In this review, we summarize the measurement of patellar anatomical parameters, K-wires placement level, and application of guiding devices, with the focus on improving the accuracy of K-wire insertion from perspectives of K-wire placement and guiding devices. This review hope to provide some inspiration for new guiding devices with auxiliary K-wire placement.

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Section: Guiding Devices and Their Clinical Applicationmentioning

confidence: 99%

Progress on Kirschner wire insertion techniques for patellar fractures

2023

PMD

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“…Robot-assisted orthopedic surgery is an eye-brain-hand coordination process like conventional surgery, and there have been reports related to TiRobot for femoral neck fractures [ 15 , 16 ]. Although the effect of treating femoral neck fractures with the help of robotics in clinical practical application is still controversial, some researchers have explained that robots have some advantages in treating femoral neck fractures [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Robotic-assisted systems for the safe and reliable treatment of femoral neck fractures: retrospective cohort study

Wang,

Zhang,

Lou

et al. 2023

J Orthop Surg Res

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Background Robots are being used in a wide range of surgical procedures. However, in clinical practice, the efficacy of orthopedic robotic-assisted treatment of femoral neck fractures is still poorly reported, particularly in terms of screw placement accuracy, femoral neck fracture healing rates and postoperative functional recovery. Moreover, there is a lack of comparative analysis between robot-assisted surgery and traditional surgical approaches. Purpose The purpose of this study was to compare the clinical outcomes of patients with femoral neck fractures treated with TiRobot-assisted hollow screw fixation with those of patients with femoral neck fractures treated with traditional surgical approaches. Methods This study included 112 patients with femoral neck fracture who were treated from March 2017 to October 2021 with percutaneous hollow screw internal fixation. These included 56 cases in the TiRobot-assisted surgery group and 56 cases in the standard surgery group. After at least 1 year of follow-up, the treatment outcomes of the two groups were compared, including the amount of intraoperative bleeding, the duration of intraoperative fluoroscopy, the number of guide pin positioning adjustments, the length of hospital stay, the accuracy rate of screw placement, the final Harris Hip Score, the fracture healing rate, and the rate of femoral head necrosis. Statistical analysis software was used to process and analyze the result. Results The TiRobot-assisted group had a statistically significant improvement over the control group in terms of intraoperative bleeding, the duration of intraoperative fluoroscopy, the number of guide pin positioning adjustments, length of hospital stay, accuracy of screw placement and incidence of femoral head necrosis (P < 0.05). There was no statistically significant difference in time to surgery, final Harris hip score and fracture healing rate (P > 0.05). Conclusion This study shows that TiRobot-assisted surgery has the advantages of short hospital stay, high safety, minimally invasive, high success rate of nail placement, and can reduce the amount of intraoperative radiation and the incidence of femoral head necrosis, thus achieving satisfactory clinical outcomes, and is worthy of clinical promotion.

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Comparison of rehabilitation outcomes between robot-assisted and freehand screw placement in treatment of femoral neck fractures: a systematic review and meta-analysis

Li,

Wang,

Dong

et al. 2024

BMC Musculoskelet Disord

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Purpose To compare the postoperative rehabilitation of femoral neck fractures treated with robot-assisted nailing and freehand nailing. Methods We systematically searched the PubMed, EMBASE, Cochrane, China National Knowledge Infrastructure(CNKI), WanFang database, China Science and Technology Journal Database (VIP) and Web of Science databases to identify potentially eligible articles. Indispensable data such as the year of publication, country, study type, robot type, age, number of patients, sex distribution, study design, and outcome indicators were extracted. The outcome indicators of interest included healing rate, length of healing time, Harris score, operation time, frequency of X-ray fluoroscopy, frequency of guide pin insertion, and intraoperative blood loss. RevMan 5.4.1 was used for the meta-analysis. Results Fourteen studies with 908 participants were included in this meta-analysis. The results showed that in terms of healing rate (SMD = 2.75, 95% CI, 1.03 to 7.32, P = 0.04) and Harris score (SMD = 2.27, 95% CI, 0.79 to 3.75, P = 0.003), robot-assisted screw placement technique scores were higher than the traditional freehand technique. Additionally, operative time (SMD = -12.72, 95% CI, -19.74 to -5.70, P = 0.0004), healing time (SMD = -13.63, 95% CI, -20.18 to -7.08, P < 0.0001), frequency of X-ray fluoroscopy (SMD = − 13.64, 95% CI, − 18.32 to − 8.95, P < 0.00001), frequency of guide pin insertion (SMD = − 7.95, 95% CI, − 10.13 to − 5.76, P < 0.00001), and intraoperative blood loss (SMD = − 17.33, 95% CI, − 23.66 to − 11.00, P < 0.00001) were lower for patients who underwent robotic-assisted screw placement than those for patients who underwent the conventional freehand technique. Conclusion Compared to the freehand nailing technique, robot-assisted nailing helps improve postoperative healing rates in patients with femoral neck fractures; shortens healing times; better restores hip function; reduces the number of intraoperative fluoroscopies, guides pin placements; reduces intraoperative bleeding; and increases perioperative safety.

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Robot-assisted vs freehand cannulated screw placement in femoral neck fractures surgery

Cited by 4 publications

References 44 publications

Progress on Kirschner wire insertion techniques for patellar fractures

Progress on Kirschner wire insertion techniques for patellar fractures

Robotic-assisted systems for the safe and reliable treatment of femoral neck fractures: retrospective cohort study

Comparison of rehabilitation outcomes between robot-assisted and freehand screw placement in treatment of femoral neck fractures: a systematic review and meta-analysis

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