Image-Guided Surgical Robotic System for Percutaneous Reduction of Joint Fractures

Article


Dagnino, G., Georgilas, I., Morad, S., Gibbons, P., Tarassoli, P., Atkins, R. and Dogramadzi, S. 2017. Image-Guided Surgical Robotic System for Percutaneous Reduction of Joint Fractures. Annals of Biomedical Engineering. 45, p. 2648–2662.
AuthorsDagnino, G., Georgilas, I., Morad, S., Gibbons, P., Tarassoli, P., Atkins, R. and Dogramadzi, S.
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.

JournalAnnals of Biomedical Engineering
Journal citation45, p. 2648–2662
ISSN0090-6964
Year2017
PublisherSpringer for Biomedical Engineering Society
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Digital Object Identifier (DOI)doi:10.1007/s10439-017-1901-x
Web address (URL)https://doi.org/10.1007/s10439-017-1901-x
Publication dates
Online16 Aug 2017
Publication process dates
Accepted09 Aug 2017
Deposited09 Mar 2020
FunderNational Institute for Health Research
Copyright holder© 2017 The Authors
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