Image-Guided Surgical Robotic System for Percutaneous Reduction of Joint Fractures.
File(s)10.1007%2Fs10439-017-1901-x.pdf (3.32 MB)
Published version
Author(s)
Type
Journal Article
Abstract
Complex joint fractures often require an open surgical procedure, which is associated with extensive soft tissue damages and longer hospitalization and rehabilitation time. Percutaneous techniques can potentially mitigate these risks but their application to joint fractures is limited by the current sub-optimal 2D intra-operative imaging (fluoroscopy) and by the high forces involved in the fragment manipulation (due to the presence of soft tissue, e.g., muscles) which might result in fracture malreduction. Integration of robotic assistance and 3D image guidance can potentially overcome these issues. The authors propose an image-guided surgical robotic system for the percutaneous treatment of knee joint fractures, i.e., the robot-assisted fracture surgery (RAFS) system. It allows simultaneous manipulation of two bone fragments, safer robot-bone fixation system, and a traction performing robotic manipulator. This system has led to a novel clinical workflow and has been tested both in laboratory and in clinically relevant cadaveric trials. The RAFS system was tested on 9 cadaver specimens and was able to reduce 7 out of 9 distal femur fractures (T- and Y-shape 33-C1) with acceptable accuracy (≈1 mm, ≈5°), demonstrating its applicability to fix knee joint fractures. This study paved the way to develop novel technologies for percutaneous treatment of complex fractures including hip, ankle, and shoulder, thus representing a step toward minimally-invasive fracture surgeries.
Date Issued
2017-08-16
Date Acceptance
2017-08-09
Citation
Annals of Biomedical Engineering, 2017, 45 (11), pp.2648-2662
ISSN
0090-6964
Publisher
Springer Verlag
Start Page
2648
End Page
2662
Journal / Book Title
Annals of Biomedical Engineering
Volume
45
Issue
11
Copyright Statement
© The Author(s) 2017
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
License URL
Identifier
PII: 10.1007/s10439-017-1901-x
Subjects
Cadaveric experimental study
Computer-assisted surgery
Medical robotics
Navigation
Percutaneous fracture surgery
Virtual planning
Publication Status
Published