Objective To investigate the clinical efficacy of computer-assisted cannulated screw internal fixation system based on error correction method for femoral neck fractures. Methods A retrospective analysis was made on the clinical data of 20 femoral neck fracture patients treated by computer-assisted cannulated screw internal fixation system based on error correction method between January 2014 and October 2015 (trial group), and 36 femoral neck fracture patients undergoing traditional manual surgery with closed reduction by cannulated screw fixation in the same period (the control group). There was no significant difference in gender, age, injury cause, side of fracture, types of fracture, and time from injury to operation between 2 groups (P>0.05). The operation time, intraoperative blood loss, intraoperative frequency of fluoroscopy and guide pin insertion, fracture healing time, fracture healing rate, and Harris hip score were compared between 2 groups. Results All incisions healed by first intention after operation, and no complication of blood vessel and nerve injury occurred. The operation time of trial group was significantly longer than that of control group (t=2.290,P=0.026), however, the intraoperative blood loss, intraoperative frequency of fluoroscopy and guide pin insertion of trial group were significantly less than those of control group (t=–10.650,P=0.000;t=18.320,P=0.000;t=–16.625,P=0.000). All patients were followed up 12-18 months (mean, 14.7 months). X-ray films showed that fracture healing was obtained in 2 groups, showing no significant difference in fracture healing time between 2 groups (t=0.208,P=0.836). No complication of ischemic necrosis of femoral head occurred during follow-up period. At last follow-up, the Harris hip score was 87.05±3.12 in trial group and was 86.78±2.83 in control group, showing no significant difference (t=0.333,P=0.741). Conclusion Computer-assisted cannulated screw internal fixation surgery based on error correction method for femoral neck fractures is better than traditional manual surgery in decreasing intraoperative radiation and surgical trauma during operation.
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.