Research progress in the use of surgical robotic systems in arthroplasty / 中华骨科杂志

ABSTRACT

With the application of robotic-assisted arthroplasty in the clinical setting during the last two decades,passive,semiautonomous,and autonomous surgical robotic systems have been developed and utilized in a wide range of surgical procedures.Such procedures include total hip arthroplasty,total knee arthroplasty,and unicompartmental knee arthroplasty.These robotic platforms can be divided into open platforms and closed systems.A navigation component is indispensable for all kinds of surgical robotic systems used in arthroplasty.Navigation components need two disparate approaches to realize three-dimensional reconstruction.Some robotic systems require preoperative imaging examination for navigation,while others only need intraoperative anatomic landmark identification.The following four types of FDA-approved surgical robotic systems are currently available for arthroplasty,the Robodoc autonomous system,the Rio haptic system,the iBlock cutting guide,and the Navio handheld system.Robotic-assisted arthroplasty reportedly facilitates more accurate milling,cutting,and drilling,allowing component aligument and bone morphing to be performed with higher precision and closer to preoperative planning.These advantages result in better postoperative function restoration and patient satisfaction.The learning curve is also acceptable for these systems.Nonetheless,robotic systems are still somewhat disappointing,because they are typically associated with prolonged surgical procedures and require adequate surgical field exposure.Moreover,the cost-effectiveness ratio of this technology in China is required for further investigation.Future designs of robotic arthroplasty systems should aim to overcome the current shortcomings in terms of security and reliability,facilitating further automation of more surgical procedures and reduction in the size of the systems.