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OBJECTIVES: To assess the accuracy and precision of acetabular component placement in robot-assisted surgery total hip arthroplasty (RAS-THA) using three different approaches. METHODS: This study is a secondary analysis from a multicenter, randomized controlled trial comparing the Trex RS Hip 1.0 robot navigation system across different surgical approaches. It involved 145 patients treated at three Chinese medical centers from June 2021 to July 2022. Patients with end-stage joint disease were randomly assigned to either the RAS or control group. Acetabular component positioning was evaluated radiographically, and registration accuracy was measured using Root Mean Square Error (RMSE). RESULTS: The overall RMSE was 0.72 mm (SD = 0.24 mm), indicating consistent accuracy regardless of surgical approach. Significant variations in anteversion were noted across groups (p = 0.001). Lateral RAS-THA showed enhanced precision. The RAS Direct Anterior Approach (DAA) group had the least deviation in the rotation center's horizontal distance (0.89 ± 1.14 mm, p = 0.0014) and minimal leg length discrepancy (2.41 ± 1.17 mm). The RAS DAA approach also produced more consistent results. CONCLUSION: Robotic assistance in THA, especially via the DAA approach, enhances the accuracy and precision of acetabular component positioning. Consistent registration accuracy across various surgical approaches confirms the reliability of these methods for THA. CLINICAL TRIAL REGISTRATION: www.clinicaltrials.gov identifier is ChiCTR2100044124.
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ObjectiveTo evaluate the effect of transcranial direct current stimulation (tDCS) on the cognitive function and quality of life in patients with Parkinson's disease. MethodsRandomized controlled trials (RCTs) on tDCS for Parkinson's disease were searched in PubMed, Web of Science, Embase, Cochrane Library, CNKI, CBM, VIP and Wanfang Data from the inception to September, 2023. Control group was administered standard Parkinson's medications or placebo, physical therapy, and cognitive rehabilitation, while treatment group received tDCS additionally. The quality of the researches was evaluated using the Cochrane Risk of Bias Tool. Data synthesis and analysis were performed using RevMan 5.4 and Stata 17.0, with heterogeneity and sensitivity analyses. ResultsEight articles were included. tDCS significantly improved the scores of Montreal Cognitive Assessment (MD = 2.00, 95%CI 1.13 to 2.87, P < 0.001). However, there was no significant difference in the scores of Parkinson's Disease Questionnaire (MD = 0.73, 95%CI -5.78 to 7.23, P = 0.830), Beck Depression Inventory-Ⅱ(MD = -0.77, 95%CI -7.14 to 5.60, P = 0.810), and Unified Parkinson Disease Rating Scale-Ⅲ (MD = 1.60, 95%CI -0.77 to 3.97, P = 0.190). ConclusiontDCS may improve cognitive function of patients with Parkinson's disease.
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The paper analyzes the status of trauma rescue and treatment informatization in Xinjiang,states the thoughts of construction of intelligent trauma medical center in southern Xinjiang (including the telemedicine system based on regional medical network,orthopedics trauma and disease diagnosis and treatment platform,etc.).It also provides the application examples and discusses the social economic benefits.
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Objective To investigate the technique and clinical results of rectangular SL-PLUS/SLR-PLUS cementless stem prosthesis in treating femoral bone defects in total hip revision surgery.Methods A retrospective analysis was performed involving 57 patients underwent total hip revision using SL-PLUS/SLR-PLUS cementless stem prosthesis for femoral defects from October 2000 to April 2014,including 22 males and 35 females with average age 62 years (range 44 to 83 years).All patients underwent unilateral surgery,21 in the left and 36 in the right.Eighteen cases of Paprosky Ⅱ,23 cases of type ⅢA and 16 cases of type ⅢB were included.Revision surgeries were performed using uncemented rectangular SL-PLUS/SLRPLUS femoral stems.Femurs were split in 12 cases without bone grafting.Acetabulum revision or acetabuloplasty were conducted in 51 cases by the use of 33 spherical cups and 18 reinforcement rings.Signs for prosthesis loosing such as transparent line around prosthesis,osteolysis and subsidence were recorded at the follow-ups.The clinical effects were evaluated using visual analogue scale (VAS),Harris score and activity daily life (ADL) score.Results The average operation was 108 min,ranging from 100 to 170 min.The average blood loss was 660 ml,ranging from 300 to 850 ml.All prostheses were placed optimally and received press-fit stability in the initial state.No neurological or vascular complication occurred during or after the operation.All incision healed at stage Ⅰ without nerve traction injury,joint dislocation,fractures,acute infection and lower limb deep vein thrombosis.The average follow-up duration was 4.8 years,ranging from 2 to 16 years.Total VAS improved from 6.54±1.56 to 2.28± 1.46 (t=17.335,P＜0.001).The Harris score improved from 46.74±7.95 to 78.46±8.25 (t=-25.012,P＜0.001),and the ADL scores increased from 56.84±6.86 to 69.39±7.56 (t=-21.309,P＜O.001).No prosthesis subsidence,prosthesis fracture and other complications occurred during the follow-up.Transparent lines around the upper part of the prosthesis were observed in 18 cases.All prosthesis-bone union was intact in the distal parts.Conclusion The segmental functional reconstruction with cementless rectangular SL-PLUS/SLR-PLUS stem prosthesis is a safe and reliable surgical procedure in patients with Paprosky Ⅱ or Ⅲ bone defects.
