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Image-Guided Surgical Robotic System for Percutaneous Reduction of Joint Fractures

Complex joint fractures often require an open surgical procedure, which is associated with extensive soft tissue damages and longer hospitalization and rehabilitation time. Percutaneous techniques can potentially mitigate these risks but their application to joint fractures is limited by the current...

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Autores principales: Dagnino, Giulio, Georgilas, Ioannis, Morad, Samir, Gibbons, Peter, Tarassoli, Payam, Atkins, Roger, Dogramadzi, Sanja
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5663813/
https://www.ncbi.nlm.nih.gov/pubmed/28815387
http://dx.doi.org/10.1007/s10439-017-1901-x
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author Dagnino, Giulio
Georgilas, Ioannis
Morad, Samir
Gibbons, Peter
Tarassoli, Payam
Atkins, Roger
Dogramadzi, Sanja
author_facet Dagnino, Giulio
Georgilas, Ioannis
Morad, Samir
Gibbons, Peter
Tarassoli, Payam
Atkins, Roger
Dogramadzi, Sanja
author_sort Dagnino, Giulio
collection PubMed
description Complex joint fractures often require an open surgical procedure, which is associated with extensive soft tissue damages and longer hospitalization and rehabilitation time. Percutaneous techniques can potentially mitigate these risks but their application to joint fractures is limited by the current sub-optimal 2D intra-operative imaging (fluoroscopy) and by the high forces involved in the fragment manipulation (due to the presence of soft tissue, e.g., muscles) which might result in fracture malreduction. Integration of robotic assistance and 3D image guidance can potentially overcome these issues. The authors propose an image-guided surgical robotic system for the percutaneous treatment of knee joint fractures, i.e., the robot-assisted fracture surgery (RAFS) system. It allows simultaneous manipulation of two bone fragments, safer robot-bone fixation system, and a traction performing robotic manipulator. This system has led to a novel clinical workflow and has been tested both in laboratory and in clinically relevant cadaveric trials. The RAFS system was tested on 9 cadaver specimens and was able to reduce 7 out of 9 distal femur fractures (T- and Y-shape 33-C1) with acceptable accuracy (≈1 mm, ≈5°), demonstrating its applicability to fix knee joint fractures. This study paved the way to develop novel technologies for percutaneous treatment of complex fractures including hip, ankle, and shoulder, thus representing a step toward minimally-invasive fracture surgeries. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s10439-017-1901-x) contains supplementary material, which is available to authorized users.
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spelling pubmed-56638132017-11-16 Image-Guided Surgical Robotic System for Percutaneous Reduction of Joint Fractures Dagnino, Giulio Georgilas, Ioannis Morad, Samir Gibbons, Peter Tarassoli, Payam Atkins, Roger Dogramadzi, Sanja Ann Biomed Eng Article Complex joint fractures often require an open surgical procedure, which is associated with extensive soft tissue damages and longer hospitalization and rehabilitation time. Percutaneous techniques can potentially mitigate these risks but their application to joint fractures is limited by the current sub-optimal 2D intra-operative imaging (fluoroscopy) and by the high forces involved in the fragment manipulation (due to the presence of soft tissue, e.g., muscles) which might result in fracture malreduction. Integration of robotic assistance and 3D image guidance can potentially overcome these issues. The authors propose an image-guided surgical robotic system for the percutaneous treatment of knee joint fractures, i.e., the robot-assisted fracture surgery (RAFS) system. It allows simultaneous manipulation of two bone fragments, safer robot-bone fixation system, and a traction performing robotic manipulator. This system has led to a novel clinical workflow and has been tested both in laboratory and in clinically relevant cadaveric trials. The RAFS system was tested on 9 cadaver specimens and was able to reduce 7 out of 9 distal femur fractures (T- and Y-shape 33-C1) with acceptable accuracy (≈1 mm, ≈5°), demonstrating its applicability to fix knee joint fractures. This study paved the way to develop novel technologies for percutaneous treatment of complex fractures including hip, ankle, and shoulder, thus representing a step toward minimally-invasive fracture surgeries. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s10439-017-1901-x) contains supplementary material, which is available to authorized users. Springer US 2017-08-16 2017 /pmc/articles/PMC5663813/ /pubmed/28815387 http://dx.doi.org/10.1007/s10439-017-1901-x Text en © The Author(s) 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Article
Dagnino, Giulio
Georgilas, Ioannis
Morad, Samir
Gibbons, Peter
Tarassoli, Payam
Atkins, Roger
Dogramadzi, Sanja
Image-Guided Surgical Robotic System for Percutaneous Reduction of Joint Fractures
title Image-Guided Surgical Robotic System for Percutaneous Reduction of Joint Fractures
title_full Image-Guided Surgical Robotic System for Percutaneous Reduction of Joint Fractures
title_fullStr Image-Guided Surgical Robotic System for Percutaneous Reduction of Joint Fractures
title_full_unstemmed Image-Guided Surgical Robotic System for Percutaneous Reduction of Joint Fractures
title_short Image-Guided Surgical Robotic System for Percutaneous Reduction of Joint Fractures
title_sort image-guided surgical robotic system for percutaneous reduction of joint fractures
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5663813/
https://www.ncbi.nlm.nih.gov/pubmed/28815387
http://dx.doi.org/10.1007/s10439-017-1901-x
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