Research On The Application Of Traumatic Orthopaedic Robot System

BackgroundRobot has been widely used in the field of surgical operation.It has the advantages of intelligence,minimally invasive,precision and so on.At present,in the field of orthopaedics,a number of robots have been applied in clinic,including spine positioning robot,joint replacement robot,fracture navigation positioning robot.But at present,there are few robots that can intellectualize and precisely reposition fracture in the field of traumatic orthopaedics.Based on the above background,the Orthopaedic Trauma Team of PLA General Hospital has developed a robot system for long bone fracture reduction,which integrates the reduction robot,positioning robot,navigation system and binocular vision system.But the previous experiments found the following problems:1.The overall system experiment operation time is long;2.There are differences in experimental accuracy;3.The unreasonable layout leads to repeated adjustment of the system position in the experiment;4.The operation process is complex and unclear.Objective1.Research and optimize the space layout of traumatic orthopaedic robot system,and construct the rational space layout system of traumatic orthopaedic robot system.2.Based on the new space layout system,through the cadaver bone specimens and cadaver experiments,the operation process was optimized in an all-round way,and the standardized operation process based on the trauma orthopaedic robot system was proposed.To provide theoretical basis and clinical operation criteria for the follow-up clinical trials of the system.Methods1.Analyse the physical parameters and working radius of each component of the robot system,then calculate the new rationalized space layout of the system.The results of data calculation and simulation analysis are validated by the experiment of cadaveric femur specimen.Fifteen pairs of cadaveric femurs were randomly divided into three groups according to the angle of the visual system at the distal end of the affected side and the lower extremity.The right femur was taken as the fracture object and the left femur as the mirror image registration.The time required to obtain the real-time spatial position of the affected femur was compared.2.Comprehensive analysis of the existing surgical procedures,the surgical procedures are divided into software and hardware operation processes.The software operation process and hardware operation process were optimized separately.The operation process was divided into non-optimization group,software optimization group and software and hardware simultaneous optimization group according to the optimization situation.The X-ray acquisition times,time and registration time before reduction of each group were compared and analyzed by cadaveric bone specimen experiment.3.Carcass simulation experiments were carried out based on the results of spatial layout and optimization of surgical procedures to simulate the real clinical surgical environment.In the experiment,a standardized surgical procedure based on this orthopaedic trauma robot system was summarized.Results1.The reasonable spatial layout of traumatic orthopaedic robot system in the operation of femoral shaft fracture is as follows:1.Operation bed layout:based on the perineal column of the operating bed,placed in the center of the operating room;2.Reduction robot layout:the distance between the midpoint of the upper platform and the perineal column of the operating bed is L=L0+15cm?L0 is the length of the contralateral femur?;3.Location robot layout:placed in the anterior superior iliac spine and femur of the injured side.On the horizontal vertical line of the median point of lateral condylar connection,the distance from the median point of the connection is L3?1.69-???L₀+5?/2?²?^1/2m;?4?The layout of binocular vision system:it can be placed at the foot of the affected side,with the lower limb at 0°,22.5° or 45°,1966 mm from the midpoint of the anterior superior iliac spine and the reset platform Marker.The optimal position of the operating table,the reset robot and the positioning robot is the only one in theory.Binocular vision systems have three possible optimal layouts.2.The shortest average time and the highest accuracy of the new rationalized spatial layout was Q1 group,and the average experimental time was 36.80±4.55 minutes.The reduction accuracy:the axial displacement error is 11.70±0.68mm,the lateral azimuth displacement error is 0.98±0.37mm and the rotation angle error is 2.06±0.85°?The lateral angulation error is 1.84±0.45°,which is significantly better than that of the control group?P<0.05?.3.Process optimization:Software operation process optimization:1.2D/2D registration upgraded to 2D/3D registration in software operation process.?2?The automatic registration function after rough registration is added to the software of navigation system.Hardware operation flow optimization:The sequence of C-arm X-ray acquisition changed from " The positive film of the proximal fracture-The lateral film of the proximal fracture-The positive film of the fracture area-The lateral film of the fracture area-The positive film of the distal fracture-The lateral film of the distal fracture " was changed to " The positive film of the proximal fracture-The positive film of the fracture area-The positive film of the distal fracture-The lateral film of the distal fracture-The lateral film of the fracture area-The lateral film of the proximal fracture " The corpse experiment showed that the average shooting times of the non-optimized group were 66.00113.75,the average shooting time was 51.33± 14.30 min,the average registration time was 82.33±22.14 min,and the average total time consumed was 133.67±27.15 min.The average shooting times of the software optimization group were 33.50±10.61,the average shooting time was 28.50±2.12 min,the average registration time was 23.00±11.31 min,and the average total time consumed was 51.50±9.20 min.The average number of shots in the optimization group was 16.25±3.10,the average shooting time was 9.25±2.99 min,the average registration time was 17.25±2.63 min,and the average total time was 26.50±1.92 min.ConclusionsIn this study,a new spatial layout of traumatic orthopaedic robot system is derived,which acquires an accuracy reduction of fracture.On the basis of the new layout,updated software and hardware could reduce the registration time and operation time of fracture reduction.The standardized operation flow chart of traumatic orthopaedic robot system?femoral shaft fracture?summarized can provide reference for follow-up research.