工具支撑在模拟股骨头颈骨软骨成形术中的应用

J. Kooyman, A. Hodgson
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引用次数: 1

摘要

支撑是人类和机器人设备采用的一种策略,通常可以描述为参与者、环境和/或工件之间的平行机械联系,它改变了工具和工件之间的机械阻抗,以提高任务性能。在这项研究中,我们研究了在骨研磨的背景下支具治疗凸轮型股髋臼撞击(FAI)病变的潜在价值。本研究的目的是评估拟议的支撑技术是否能够使用户比目前使用的关节镜技术更准确、更快速地进行凸轮切除术。材料/方法测试样品由市售成人近端股骨的白色聚氨酯塑料复制品组成,激光扫描以获得真实的表面信息。然后在股骨颈前上区域的股骨表面上放置一个黑色凸轮病变,为模拟骨软骨成形术创造一个清晰的视觉切除边界。试验对象为4名无手术经验的成年男性(25±3岁)。测试条件包括两个二元因素:(1)支架与非支架-支架病例引入了一个球形轴承工具支撑,安装在关节镜门静脉的大约前外侧位置。(2)速度与准确性-受试者被指示在适度考虑时间的情况下尽可能快或尽可能准确地进行切除。在切除病变后,对股骨进行激光扫描以获得切除后的表面几何形状,准确度报告为前上颈区域切除前后扫描的RMS偏差。结果在准确性和速度两种情况下,支具都倾向于减少错误(约7-14%)和任务持续时间(约32-52%),尽管考虑到本初步研究的受试者数量较少,这些差异没有统计学意义。结论支具可以提高未经训练的受试者切除凸轮病变的速度和准确性,这一假设是正确的。受试者之间的标准偏差很高,可能是由于任务的难度和使用手持电动工具的经验差异,因此需要额外的受试者来验证这里确定的趋势。
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TOOL BRACING FOR PERFORMANCE IMPROVEMENT IN SIMULATED FEMORAL HEAD-NECK OSTEOCHONDROPLASTY
Introduction Bracing, a strategy employed by humans and robotic devices, can be generally described as a parallel mechanical link between the actor, the environment, and/or the workpiece that alters the mechanical impedance between the tool and workpiece in order to improve task performance. In this study we investigated the potential value of bracing in the context of bone milling to treat cam-type femoroacetabular impingement (FAI) lesions. The goal of this study was to evaluate whether a proposed bracing technique could enable a user to perform a cam resection more accurately and quickly than a currently employed arthroscopic technique. Materials/Methods Test samples consisted of white urethane plastic reproductions of a commercially available adult proximal femur, which were laser scanned to obtain ground-truth surface information. A black cam lesion was then cast onto the surface of the femur in the anterosuperior region of the femoral neck, creating a clear visual resection boundary for the simulated osteochondroplasty. Test subjects were 4 adult males (25 +/− 3 years) with no surgical experience. Test conditions included two binary factors: (1) Braced vs. Unbraced – The braced case introduced a spherical bearing tool support mounted in the approximate anterolateral arthroscopic portal position. (2) Speed vs. Accuracy – The subject was instructed to perform the resection as quickly as possible or as accurately as possible with a moderate regard for time. Following the removal of the lesion, femurs were laser scanned to acquire the post-resection surface geometry, with accuracy being reported as RMS deviation between the pre- and post-resection scans over the anterosuperior neck region. Results In both accuracy and speed cases, bracing tended to reduce errors (on the order of 7–14%) and task duration (on the order of 32–52%), although given the small number of subjects in this pilot study, these differences were not statistically significant. Conclusion These results provide some encouragement that our hypothesis that bracing can improve both speed and accuracy of cam lesion resection by untrained subjects may be true. The standard deviations between subjects are high and are likely due to both the difficulty of the task and differences in experience using handheld power tools, so additional subjects would be needed to verify the trends identified here.
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