Better precision of a new robotically assisted system for total knee arthroplasty compared to conventional techniques: A sawbone model study.

BACKGROUND: The purpose of this study was to compare the accuracy of this new HURWA robotic-assisted total knee arthroplasty (TKA) technique to the accuracy of the conventional technique in a sawbone model. METHODS: The HURWA robotic-assisted TKA system was applied in the robotic group. After bone resection, all of these sawbones were scanned by the use of a structured light scanning system. Measurements of bone resections, femoral coronal and sagittal measurements, and tibial coronal and sagittal measurements were recorded. RESULTS: Compared to the conventional technique, the HURWA robotic-assisted system significantly improved the accuracy of the bone resection levels and angles. In the robotic group, the accuracy of all of the bone resection levels was below 0.6 mm (with standard deviation [SD] below 0.6 mm), and all of the bone resection angles were below 0.6° (with SD below 0.4°). CONCLUSION: Our data suggest that this novel HURWA robotic-assisted system can significantly improve the accuracy of bone resection levels and angles.

A new robotically assisted system for total knee arthroplasty: A sheep model study.

BACKGROUND: We investigated the accuracy and safety of a new HURWA robotic-assisted total knee arthroplasty (TKA) system in a sheep model. METHODS: Ten male small-tailed Han sheep were used in this study. Sheep were imaged by computed tomography scan before and after bone resection and the cutting errors between actual bone preparation and preoperative planning of the femur and tibia in three dimensions were measured. RESULTS: The overall accuracies after surgery compared with that from preoperative surgical planning of the left and right femurs were 1.93 ± 1.02° and 1.93 ± 1.23°, respectively. Additionally, similarly high overall accuracies for the left and right tibia of 1.26 ± 1.04 and 1.68 ± 0.92°, respectively, were obtained. The gap distances of the distal cut, anterior chamfer, anterior cut, posterior chamfer and posterior cut on the medial side were 0.47 ± 0.35 mm, 0.41 ± 0.37 mm, 0.12 ± 0.26 mm, 0.41 ± 0.44 mm and 0.12 ± 0.23 mm, respectively. No intraoperative complications, such as intraoperative fracture, massive bleeding or death, occurred. CONCLUSION: This new HURWA robotic-assisted TKA system is an accurate and safe tool for TKA surgery based on the sheep model.

Perioperative Measurement of Radiation Exposure to Radiation-Sensitive Organs of Patients Undergoing Lumbar Surgeries Using a Thermoluminescent Dosimeter.

OBJECTIVE: To introduce a method of accurately measuring the equivalent dose received by radiation-sensitive organs using the thermoluminescent dosimeter (TLD) and to provide reference values for future studies associated with radiation protection in patients undergoing lumbar spine surgeries. METHODS: After careful selection and preparation, TLD chips were used to obtain measurements from the eyes, thyroid glands, breasts, and gonads of 20 patients undergoing lumbar spine surgeries. The results were obtained via air kerma conversion-related calculations. RESULTS: The overall radiation exposures absorbed perioperatively by the eyes, thyroid glands, right breasts, left breasts, right ovaries, left ovaries, and testes were 0.41 ± 0.13, 1.43 ± 0.45, 6.95 ± 3.63, 9.50 ± 6.14, 29.86 ± 28.62, 23.47 ± 22.10, and 5.41 ± 1.86 mSv, respectively. A single computed tomography (CT) scan contributed to more than 75% of the overall dose received regardless of the position used. CONCLUSIONS: Patients received significantly higher radiation doses from CT scans than from regular digital radiograph examinations. These radiation doses were concentrated in the regional area of scanning. Our results indicate the necessity and benefits of radiation protection measures, especially for the organs researched herein, when patients undergoing lumbar surgeries require radiographic diagnostic examinations.

[Meta-analysis of lumbar disc herniation in Chinese adolescents].

OBJECTIVE: To provide evidence-based medicine rationales for the diagnosis and treatment of lumbar disc herniation (LDH) in Chinese adolescents. METHODS: The related medical literature of pediatric LDH between January 1990 and December 2012 was collected by retrospective searches of WANGFANG and CNKI databases. The data concerning mechanism, clinical manifestations, diagnosis and treatment were recorded and analyzed. RESULTS: A total of 1208 cases of LDH in adolescents were retrieved from 45 articles. Most of them were males (74.2%). And the primary cause was trauma (65.9%). Their clinical presentations were characterized by mild symptoms and serious physical signs. And 87.0% of them had a positive straight-leg raising test. Single-level intervertebral disk protrusion accounted for 92%. And the levels were at L4-L5 (54.7%) and L5-S1 (37.6%). There was a higher incidence of lumbar scoliosis deformity (38.2%), lumbar spine physiological curvature change (41.4%) and loss of vertebral height (33.6%) in adolescents than adults. There were many different treatments for pediatric LDH. Each method had its own advantages and disadvantages. The success rates of micro endoscopic discectomy (MED) and open discectomy were more than 90%. CONCLUSION: Trauma is a common cause of pediatric LDH. Males are more frequently affected. The single-level protrusion of L4/5 or L5/S1 has a much higher incidence. Positive straight-leg raising test and imaging findings of lumbar scoliosis deformity, lumbar spine physiological curvature change and a loss of vertebral height may aid the diagnosis. Normally conservative treatment is offered. And chemonucleolysis, MED and open discectomy are alternative options.