目的:探讨实时跟踪与虚拟现实技术(RTVI)辅助创伤骨科手术机器人术中对准治疗股骨颈骨折的效果及对治疗效果的影响。
方法:回顾性分析了2020年9月至2022年9月接受创伤骨科机器人手术治疗的60例股骨颈骨折患者。根据手术期间是否使用RTVI技术辅助机器人手术,将患者分为两组。RTVI组28例(男12例,女16例),平均年龄(46.2±9.3)岁,年龄28~60岁。简易天脊手术机器人组32例,包括15名男性和17名女性,年龄(48.2±7.8)岁,年龄32~58岁。已注册的透视检查次数,操作时间,术中透视总次数,术中失血,观察并记录两组患者的住院时间。所有患者术后均接受定期随访,常规检查髋部X射线以记录花园对齐指数,骨折愈合时间,术后并发症,哈里斯得分。
结果:60例患者均获随访。RTVI组随访9~16个月,平均(13.0±1.2)个月。单纯天脊手术机器人组随访10~14个月,平均(12.0±1.3)个月。在后续期间,两组患者股骨颈骨折愈合良好,未发生内固定松动、切口感染等并发症。已注册的透视检查次数,操作时间,RTVI组患者术中透视次数明显优于单纯天脊手术机器人组(P<0.01)。术中出血量差异无统计学意义,住院,园林线形指标,骨折愈合时间,两组患者髋关节Harris评分差异无统计学意义(P>0.05)。
结论:尽管RTVI技术在股骨颈骨折手术机器人的辅助下对其术后效果影响不大,它可以有效地减少操作时间,术中X射线投射的数量,以及术中辐射暴露给患者的风险。它还缩短了操作人员的学习曲线,更好地反映了创伤骨科手术机器人的精度和效率。
OBJECTIVE: To investigate the effectiveness of real-time tracking and virtual reality technology(RTVI) used to assist the intraoperative alignment of the trauma orthopaedic surgery robot for the treatment of femoral neck fractures and its impact on the treatment outcome.
METHODS: A retrospective analysis was conducted on 60 patients with femoral neck fractures treated with trauma orthopedic robotic surgery from September 2020 to September 2022. Patients were divided into two groups according to whether RTVI technology was used during surgery to assist robotic surgery. There were 28 patients in the RTVI group (12 males and 16 females), with an average age of (46.2±9.3) years old ranging from 28 to 60 years old. There were 32 patients in the simple Tianji surgical robot group, including 15 males and 17 females, aged (48.2±7.8) years old ranging from 32 to 58. The number of registered fluoroscopy, operation time, total number of intraoperative fluoroscopy, intraoperative blood loss, and hospitalization time of the two groups of patients were observed and recorded. All patients received regular follow-up after surgery, and hip X-rays were routinely reviewed to record Garden alignment index, fracture healing time, postoperative complications, and Harris score.
RESULTS: All 60 patients were followed up. The RTVI group was followed up for 9 to 16 months with an average of (13.0±1.2) months, and the Tianji surgical robot group alone was followed up for 10 to 14 months with an average of (12.0±1.3) months. During the follow-up period, the femoral neck fractures of both groups of patients healed well, and no complications such as internal fixation loosening and incision infection occurred. The number of registered fluoroscopy, operation time, and number of intraoperative fluoroscopy of patients in the RTVI group were significantly better than those in the simple Tianji surgical robot group(P<0.01). There was no statistically significant difference in intraoperative blood loss, hospital stay, Garden alignment index, fracture healing time, and hip Harris score between two groups(P>0.05).
CONCLUSIONS: Although RTVI technology assisted by the surgical robot for femoral neck fracture surgery has little impact on its postoperative outcome, it can effectively reduce the operating time, the number of intraoperative X-ray projections, and the risk of intraoperative radiation exposure to patients. It also shortened the learning curve of the operator and better reflected the precision and efficiency of the trauma orthopaedic surgery robot.