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Accuracy and Safety of Robot‐Assisted Drilling Decompression for Osteonecrosis of the Femoral Head

OBJECTIVE: To investigate the safety and superiority of robot‐assisted femoral head drilling decompression in the treatment of femoral head necrosis. METHODS: A total of 63 patients who underwent borehole decompression of the femoral head in our hospital from January 2016 to March 2019 were recruite...

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Autores principales: Luo, Jin, Yan, Ya‐jing, Wang, Xiao‐dong, Long, Xu‐dong, Lan, Hai, Li, Kai‐nan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons Australia, Ltd 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7307221/
https://www.ncbi.nlm.nih.gov/pubmed/32394643
http://dx.doi.org/10.1111/os.12678
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author Luo, Jin
Yan, Ya‐jing
Wang, Xiao‐dong
Long, Xu‐dong
Lan, Hai
Li, Kai‐nan
author_facet Luo, Jin
Yan, Ya‐jing
Wang, Xiao‐dong
Long, Xu‐dong
Lan, Hai
Li, Kai‐nan
author_sort Luo, Jin
collection PubMed
description OBJECTIVE: To investigate the safety and superiority of robot‐assisted femoral head drilling decompression in the treatment of femoral head necrosis. METHODS: A total of 63 patients who underwent borehole decompression of the femoral head in our hospital from January 2016 to March 2019 were recruited. Patients were divided into two groups for comparison according to surgical methods. In the robot‐assisted surgery group, there were 30 cases with 41 femoral heads. The conventional group had 33 cases and 46 femoral heads. All patients signed the consent form before the operation. The follow‐up time was 6 months. The incision lengths, operation times, intraoperative blood loss, intraoperative fluoroscopies, guide needle punctures, postoperative Harris scores, and postoperative complications of the two groups were compared. RESULTS: The incision length of the robot surgery group was 5.16 ± 0.41 cm, while that of the traditional surgery group was 7.42 ± 0.50 cm. The operation time of the robot surgery group was 46.99 ± 4.94 min, while that of the traditional surgery group was 55.01 ± 6.19 min. The fluoroscopy frequency of the robot surgery group was 10.50 ± 1.78 times, while that of the traditional surgery group was 17.91 ± 2.20 times. The intraoperative blood loss in the robotic surgery group was 20.62 ± 2.52 mL, while that in the conventional surgery group was 52.72 ± 3.39 mL. In the robot operation group, each femoral head guide needle was punctured three times, and the puncture was successful one time. The number of guided needle punctures in the traditional group was 8.02 ± 1.73. The difference between the two groups was statistically significant (P < 0.05). The Harris score was 69.53 ± 7.51 in the robot surgery group and 68.38 ± 7.26 in the traditional surgery group one month after surgery, 78.52 ± 6.49 in the robot surgery group and 76.41 ± 7.95 in the traditional surgery group three months after surgery, and 83.32 ± 8.62 in the robot surgery group and 81.74 ± 6.20 in the traditional surgery group six months after surgery. There was no significant difference between the two groups (P > 0.05). In the traditional group, there was one case of incision infection and one case of femoral head collapse during follow‐up. In the robot group, there were no complications, such as incision infection and deep vein thrombosis. No collapse of the femoral head was found in the robot group during follow‐up. CONCLUSION: The positioning system of the orthopaedic robot is an ideal method for the treatment of femoral head necrosis. This method has the advantages of simple operation, accurate drilling, a short operation time, less surgical trauma, less radioactivity, and good recovery of hip joint function.
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spelling pubmed-73072212020-06-23 Accuracy and Safety of Robot‐Assisted Drilling Decompression for Osteonecrosis of the Femoral Head Luo, Jin Yan, Ya‐jing Wang, Xiao‐dong Long, Xu‐dong Lan, Hai Li, Kai‐nan Orthop Surg Clinical Articles OBJECTIVE: To investigate the safety and superiority of robot‐assisted femoral head drilling decompression in the treatment of femoral head necrosis. METHODS: A total of 63 patients who underwent borehole decompression of the femoral head in our hospital from January 2016 to March 2019 were recruited. Patients were divided into two groups for comparison according to surgical methods. In the robot‐assisted surgery group, there were 30 cases with 41 femoral heads. The conventional group had 33 cases and 46 femoral heads. All patients signed the consent form before the operation. The follow‐up time was 6 months. The incision lengths, operation times, intraoperative blood loss, intraoperative fluoroscopies, guide needle punctures, postoperative Harris scores, and postoperative complications of the two groups were compared. RESULTS: The incision length of the robot surgery group was 5.16 ± 0.41 cm, while that of the traditional surgery group was 7.42 ± 0.50 cm. The operation time of the robot surgery group was 46.99 ± 4.94 min, while that of the traditional surgery group was 55.01 ± 6.19 min. The fluoroscopy frequency of the robot surgery group was 10.50 ± 1.78 times, while that of the traditional surgery group was 17.91 ± 2.20 times. The intraoperative blood loss in the robotic surgery group was 20.62 ± 2.52 mL, while that in the conventional surgery group was 52.72 ± 3.39 mL. In the robot operation group, each femoral head guide needle was punctured three times, and the puncture was successful one time. The number of guided needle punctures in the traditional group was 8.02 ± 1.73. The difference between the two groups was statistically significant (P < 0.05). The Harris score was 69.53 ± 7.51 in the robot surgery group and 68.38 ± 7.26 in the traditional surgery group one month after surgery, 78.52 ± 6.49 in the robot surgery group and 76.41 ± 7.95 in the traditional surgery group three months after surgery, and 83.32 ± 8.62 in the robot surgery group and 81.74 ± 6.20 in the traditional surgery group six months after surgery. There was no significant difference between the two groups (P > 0.05). In the traditional group, there was one case of incision infection and one case of femoral head collapse during follow‐up. In the robot group, there were no complications, such as incision infection and deep vein thrombosis. No collapse of the femoral head was found in the robot group during follow‐up. CONCLUSION: The positioning system of the orthopaedic robot is an ideal method for the treatment of femoral head necrosis. This method has the advantages of simple operation, accurate drilling, a short operation time, less surgical trauma, less radioactivity, and good recovery of hip joint function. John Wiley & Sons Australia, Ltd 2020-05-11 /pmc/articles/PMC7307221/ /pubmed/32394643 http://dx.doi.org/10.1111/os.12678 Text en © 2020 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Articles
Luo, Jin
Yan, Ya‐jing
Wang, Xiao‐dong
Long, Xu‐dong
Lan, Hai
Li, Kai‐nan
Accuracy and Safety of Robot‐Assisted Drilling Decompression for Osteonecrosis of the Femoral Head
title Accuracy and Safety of Robot‐Assisted Drilling Decompression for Osteonecrosis of the Femoral Head
title_full Accuracy and Safety of Robot‐Assisted Drilling Decompression for Osteonecrosis of the Femoral Head
title_fullStr Accuracy and Safety of Robot‐Assisted Drilling Decompression for Osteonecrosis of the Femoral Head
title_full_unstemmed Accuracy and Safety of Robot‐Assisted Drilling Decompression for Osteonecrosis of the Femoral Head
title_short Accuracy and Safety of Robot‐Assisted Drilling Decompression for Osteonecrosis of the Femoral Head
title_sort accuracy and safety of robot‐assisted drilling decompression for osteonecrosis of the femoral head
topic Clinical Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7307221/
https://www.ncbi.nlm.nih.gov/pubmed/32394643
http://dx.doi.org/10.1111/os.12678
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