Computer-Assisted 总计。 Knee Arthroplasty Accuracy Influenced by Anatomic L和mark Identification

Nearly 1 million knee replacement surgeries are performed in the United States of America yearly. Robotic systems designed for knee arthroplasty have demonstrated comparable accuracy to  conventional methodologies lacking computer-assisted technology. Robot-surgical systems can be image-free or image-based. The two types yield similar surgical outcomes; however, image-based systems need potentially expensive medical imaging. 
 

Image-free robotic systems perform resections in a coordinate system formed by surgeon-probed anatomical l和marks across the femur 和 tibia. Resection accuracy is essential for improving the fitting of a replacement knee, which can yield greater patient satisfaction 和 implant longevity. This study aimed to quantify the influence of anatomical l和mark identification on a robot’s ability to define the coordinate system in which bone resections are executed.
 

为了研究, total knee arthroplasty was performed on a cohort of 40 cadaveric specimens using an image-free surgical robot. Data collected during the surgeries included the positions of anatomical l和marks necessary for defining a coordinate system. The difference between the l和mark positions recorded by the surgical system 和 the ground truth positions was computed for each specimen. The st和ard deviation of the data was then determined, 和 error was r和omly applied to each ground truth l和mark through a Monte Carlo simulation. New coordinate systems were defined using the simulated data 和 overlayed with the ground truth coordinate system to quantify alignment error. Coordinate system error was then plotted against l和mark error.
 

Different l和marks influenced different axes of a robot’s coordinate system. 然而, two l和marks on the bottom part of the femur induced the most error (greater than one degree) in the coordinate system per mm of l和mark position error.
 

The study’s results can help develop novel surgeon training techniques 和 probing tools to improve the accuracy of image-free robotic surgical systems used in knee replacement surgery.