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BACKGROUND:The application of robot-assisted technology for total knee arthroplasty is one of the current research hotspots.Since the 1980s,robot-assisted technology has been introduced into total knee arthroplasty outside China to achieve accurate osteotomy and good recovery of lower limb alignment.After decades of use,the robot has continuously improved its performance with new iterations,but has been criticized for increasing perioperative time and surgical trauma. OBJECTIVE:To summarize the advantages and disadvantages of current orthopedic surgical robots in total knee arthroplasty. METHODS:PubMed database and CNKI were searched to analyze the advantages and disadvantages of robot-assisted total knee arthroplasty in surgical trauma.English search terms were"arthroplasty,replacement,knee,knee replacement arthroplasty,procedure,robotic surgical,total knee arthroplasty,arthroplasty,replacement,knee,robotic-assisted".The Chinese search terms were"robot-assisted,robotic arm,knee osteoarthritis,arthritis".After the initial screening of all articles according to the inclusion and exclusion criteria,62 articles with high quality and relevance were reviewed. RESULTS AND CONCLUSION:(1)Robot-assisted total knee arthroplasty did not increase the degree of surgical trauma in patients,and showed a lower trauma effect than conventional manual total knee arthroplasty.(2)Robot-assisted total knee arthroplasty has the advantages of accurate auxiliary osteotomy,individualized prosthesis implantation,better protection of soft tissue around the knee joint,reduction of analgesic drug use,reduction of postoperative inflammatory index changes,and shortening of hospital stay.However,there are also shortcomings such as prolonged operation time,increased complications,and increased medical costs.(3)It is concluded that preliminary clinical application studies have shown that robot-assisted total knee arthroplasty can reduce surgical trauma,but it is necessary to be alert to potential risks.Simultaneously,its exact advantages compared with conventional manual total knee arthroplasty need to be verified by large-sample randomized controlled studies and long-term follow-up.
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Objective:To compare the early clinical outcomes between domestic robot-assisted total knee arthroplasty (RA-TKA) and conventional manual total knee arthroplasty (CM-TKA) for patients with primary knee osteoarthritis.Methods:Embase, Pubmed, Web of Science, Zhi.com and Wanfang databases from January 2015 to April 2023 were searched for clinical controlled trials (RCTs) comparing the clinical outcomes between RA-TKA and CM-TKA. After literature screening, quality evaluation and data extraction according to the criteria required, Revman 5.3 software was applied to perform a Meta-analysis of the literature data. The operation time, intraoperative bleeding, hip-knee-ankle angle (HKA), HKA bias value, frontal femoral component (FFC), frontal tibia component (FTC), lateral femoral component (LFC), lateral tibia component (LTC), Knee Society Score (KSS), visual analogue scale (VAS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), knee mobility, Hospital for Specialty Surgery (HSS) knee score, length of hospital stay, and rate of complications were compared between the RA-TKA and CM-TKA patients.Results:Eight RCTs and 449 patients were included, with 221 patients in the RA-TKA group and 228 ones in the CM-TKA group. The Meta-analysis showed that the RA-TKA group had significantly longer operation time ( MD=18.41, 95% CI: 11.28 to 25.23, P<0.001), significantly better HKA ( MD=0.41, 95% CI: 0.06 to 0.76, P=0.020), significantly better HKA bias value ( MD=-0.92, 95% CI: -1.25 to -0.60, P<0.001), significantly better FTC ( MD=0.38, 95% CI: 0.08 to 0.67, P=0.010), significantly better LTC ( MD=1.71, 95% CI: 0.94 to 2.48, P<0.001), and significantly better knee mobility ( MD=-2.23, 95% CI: -4.18~-0.27, P=0.030) than the CM-TKA group. However, the differences were not statistically significant between the 2 groups in the intraoperative bleeding, FFC, LFC, KSS, VAS, WOMAC, HSS, length of hospital stay, or rate of complications ( P>0.05). Conclusion:Use of a domestic robot to assist conventional manual TKA can significantly improve the accuracy of prosthesis fixation and reconstruct the alignment of lower limb better, showing potential advantages in promoting functional recovery of the knee for the patients.
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Objective To explore the correlation between ponticulus of atlas and abnormal morphology of V3 segment of vertebral artery. Methods All patients included in this study were underwent CTA and 3D reconstruction examination of intracranial ponticulus and cervical in our workstation, as well as the site, shape of petals and its relationship with vertebral artery was observed. The diameter, shape and trail of vertebral V3 segment were measured and analyzed. The results were analyzed byχ2 test. Results A total of 195 sides (157 cases) ponticulus were detected in 613 cases (1 226 sides), the abnormal morphology of V3 segment of vertebral artery were 103 sides and combined with ponticulus 69 sides among them, including (according to side): the collectivity was 8.4% (103/1 226), combination ponticulus was 35.4% (69/195), uncombination ponticulus was 3.3%(34/1 031), and the risk with ponticulus was increased compared with no ponticulus, and showed statistical significance by Chi-square test(χ2=215.679,P=0.001). The difference of abnormality of vertebral artery was performanced in number, site and shape of ponticulus, we found that the ponticulus composite was 57.1%(12/21) and higher than ponticulus simple 32.8%(57/174)(χ2=4.873,P=0.027), the ponticulus borderl was 68.8%(11/16) which was also higher than ponticulus posticus(27.2%) and ponticulus lateralis(36.4%)in the ponticulus simple(χ2=11.357,P=0.030), the sharp ones (64.2%) were higher than the blunt(14.6%)in the tip of bony processes of the incomplete type ponticulus(χ2=26.813, P=0.001),the smaller ones were higher than the larger in the distance of the gap between the two tips of bony processes in the incomplete type ponticulus(χ2=9.212,P=0.010), and the smallerones(87.5%)were also higher than the larger(28.6%)in the diameter of the hole of complete type ponticulus(χ2=18.193,P=0.001), all of the above ones showed statistical significance among all groups by Chi-square test (P<0.05). Conclusions Ponticulus of atlas can significantly increase the risk of abnormal morphology of V3 segment of vertebral artery, and the differences of abnormality of vertebral artery were performed in number, site and shape of ponticulus, which included the ponticulus composite, ponticulus borderland, the shape tip of bony processes, the moderate distance between the two lip of bony processes, and the smaller diameter of complete type Ponticulus.
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Objective To discuss pharmaceutical care for patients with acute pancreatitis , investigate and expand the role of clinical pharmacists in the clinical treatment .Methods To prepare pharmaceutical care , medication guidance and interventions of life were offered to an acute pancreatitis patient .Results The patient′s medication compliance was enhanced and good for the clinical ther-apy.Conclusion Clinical pharmacists could play an important role in patient′s implementation of a comprehensive and effective pro-gram of individual administration .
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OBJECTIVE:To establish the relationship of clinical pharmacist with hemodialysis patients through pharmaceutical care and select individualized therapeutic regime by pharmacists and physicians in order to reduce high blood pressure and improve quality of life in hemodialysis patients. METHODS:Hemodialysis patients with hypertension being in line with included cretria were collected and randomly divided into pharmaceutical care group(n=20) and non-pharmaceutical care group(n=21). RESULTS:After 3 months of treatment,in pharmaceutical care group SBP was decreased from 158 mmHg to 139 mmHg and DBP from 95 mmHg to 84 mmHg;in non-pharmaceutical care group SBP was decreased from 155 mmHg to 152 mmHg and DBP from 96 mmHg to 93 mmHg. There was significant difference between pharmaceutical care group and non- pharmaceutical care group (P