Robot-assisted vs freehand cannulated screw placement in femoral neck fractures surgery: A systematic review and meta-analysis

Medicine (Baltimore). 2021 May 21;100(20):e25926. doi: 10.1097/MD.0000000000025926.

Abstract

Background: Several studies have reported that medical robot-assisted method (RA) might be superior to conventional freehand method (FH) in orthopedic surgery. Yet the results are still controversial, especially in terms of femoral neck fractures surgery. Here, 2 methods were assessed based on current evidence.

Methods: Electronic databases including Cochrane Library, PubMed, Web of Science. and EMBASE were selected to retrieved to identify eligible studies between freehand and RAs in femoral neck fractures, with 2 reviewers independently reviewing included studies as well as collecting data.

Results: A total of 5 studies with 331 patients were included. Results indicated that 2 surgical methods were equivalent in terms of surgical duration, Harris score, fracture healing time, fracture healing proportion and complications, while RA showed clinical benefits in radiation exposure, intraoperative bleeding, total drilling times, and screw parallelism.

Conclusions: Current literature revealed significantly difference between 2 techniques and suggested that RA might be beneficial for patients than freehand method.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Blood Loss, Surgical / statistics & numerical data
  • Femoral Neck Fractures / surgery*
  • Femur Head / diagnostic imaging
  • Femur Head / injuries
  • Femur Head / surgery
  • Fluoroscopy / adverse effects
  • Fluoroscopy / statistics & numerical data
  • Fracture Fixation, Internal / adverse effects*
  • Fracture Fixation, Internal / instrumentation
  • Fracture Fixation, Internal / methods
  • Fracture Healing
  • Humans
  • Operative Time
  • Pedicle Screws
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Robotic Surgical Procedures / adverse effects*
  • Robotic Surgical Procedures / instrumentation
  • Time Factors
  • Treatment Outcome