Objective To summarize the technological evolution, clinical advantages, and cutting-edge development trends of cementless prostheses for total knee arthroplasty (TKA), so as to provide a reference for the clinical treatment of end-stage knee osteoarthritis and the research and development of prosthesis technology. MethodsRelevant researches and technical achievements over more than 40 years in the field of cementless prostheses for TKA were systematically reviewed. This study focused on iterative upgrades and carried out comprehensive analysis combined with clinical application data and revision-related studies. Results Benefiting from the advantage of cementless fixation, cementless prostheses can effectively avoid bone-cement-related complications. Prosthesis coating materials have undergone multi-generation iterations, and friction-interface materials present favourable prospects for bionic-oriented application. Robot-assisted surgical systems can markedly improve the primary-fixation reliability of biological prostheses.Conclusion Materials and surgical-assisted techniques for cementless prostheses keep being innovated and their clinical outcomes are continuously optimized. Artificial-intelligence-aided surgical planning and patient-specific customized prostheses will become the core research directions in this field.
Objective To evaluate the effectiveness and precision of the domestic total hip arthroplasty (THA)-assisted robotic system ROPA through artificial bone experiments. MethodsRobot-assisted THA was performed on 16 artificial bone models (8 left hips and 8 right hips) using the ROPA system. Preoperative CT scans were imported into the ROPA system for three-dimensional reconstruction and preoperative planning. Component size, acetabular cup position (anteversion and abduction angles), and osteotomy parameters (femoral neck osteotomy distance, offset, leg length discrepancy, and acetabular reaming bone volume) were recorded. Intraoperative probe verification accuracy, matching accuracy, remaining reaming distance, and remaining press-fit distance were documented. Postoperative three-dimensional scanning was performed to measure actual parameters, which were compared with planned values to calculate deviations. Results Osteotomy experiments were successfully completed on all 16 hip models. Component sizes were consistent with the preoperative plan in all 16 hip models. Deviations between actual and planned values were as follows: Anteversion angle was (0.79±1.69)° and abduction angle was (0.19±2.23)°. According to the initial position of acetabular cup, abduction angle was 40° and anteversion angle was 20°. The deviation of acetabular cup anteversion angle was (40.79±1.69)° and abduction angle was (20.19±2.23)°. All acetabular cups were implanted in the Lewinnek safe zone. The femoral neck osteotomy distance was (0.31±0.38) mm, the leg length discrepancy was (0.79±1.16) mm, the hip offset was (0.69±2.21) mm, and the acetabular fossa reaming bone volume was (0.03±0.06) mm, all of which met the acceptance criteria. The probe verification accuracy was (0.18±0.16) mm, the intraoperative registration accuracy was (0.50±0.22) mm, the remaining reaming distance was (?0.19±1.05) mm, and the remaining press-fit distance was (1.88±0.89) mm, all of which were in line with the expected design error range. Conclusion The domestic THA-assisted robotic system ROPA demonstrated favorable osteotomy accuracy, operational performance, effectiveness, and precision in artificial bone experiments. However, its long-term efficacy still requires further verification through clinical trials.