Figure 8 - uploaded by Srinath Kamineni
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Anatomical landmarks, such as the medial epicondyle, ulnar nerve, olecranon, lateral epicondyle, and radial head, are outlined before surgical incision. This image was obtained from Camp et al., 2016.
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... the early 1970s, the arthroscopic anatomy of the elbow and the indications for elbow arthroscopy were vigorously researched and later published in a report by Dr. K Ito in 1979. [4] In 1985, Andrews and Carson first described a way to help ensure this by identifying and outlining anatomical and neurovascular structures, such as the medial and lateral epicondyles, the olecranon, the radiocapitellar joint, and the ulnar nerve [ Figure 8], through palpation before joint distension. [8] Portal establishment using the outside-in and inside-out techniques has both been surgically explored, but ultimately the outsidein technique has become the preferred method, for most portals. ...
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Background:
The aim of this study was to assess the functional outcomes and time to improve after the modified arthroscopic technique (recession technique) by using a knife to sharply cut the extensor carpi radialis brevis (ECRB) tendon origin in patients with recalcitrant tennis elbow.
Methods:
In a prospective study, we included 11 consecutive...
Citations
... 1,2 Elbow arthroscopy is a common arthroscopic surgery in orthopedics that is commonly used for the management of elbow arthritis, stiffness, tendinosis, fractures, and instability in a minimally invasive fashion. 3 During traditional elbow arthroscopy, the surgeon needs to hold an arthroscope with one hand while conducting the surgery with the other hand under the arthroscope view. The arthroscope view may need to be adjusted many times during the surgery in order to observe the surgical site from different perspectives or change to another surgical site. ...
... In the steady state of setpoint regulation (i.e., q = constant,q =q = 0), it will have, (a) joint friction disappeared, i.e., τ fric = 0; (b) model error (∆Mq + ∆Sq + ∆G) will be reduced to only gravity compensation error (∆G); (c) only the gravity of the external constant payloads exists for external disturbances (e.g., the surgical tools attached to the robot EE). By applying these conditions, the dynamic model (1) will become (3). ...
Robot-assisted arthroscopic surgery has been receiving growing attention in the field of orthopedic surgery. Most of the existing robot-assisted surgical systems in orthopedics place more focus on open surgery than minimally invasive surgery (MIS). In traditional arthroscopic surgery, the surgeon needs to hold an arthroscope with one hand while performing the surgical operations with the other hand, which can restrict the dexterity of the surgical performance and increase the cognitive load. On the other hand, the surgeon heavily relies on the arthroscope view when conducting the surgery, whereas the arthroscope view is a largely localized view and lacks depth information. To assist the surgeon in both scenarios, in this work, we develop a two-arm robotic system. The left-arm robot is used as a robot-assisted arthroscope holder, and it can hold the arthroscope still at a designated pose and reject all other potential disturbances, while also allowing the operator to move it via a pedal switch whenever needed. The left-arm robot is implemented with an impedance controller and a gravity iterative learning (Git) scheme, where the former can provide compliant robot behavior, thus ensuring a safe human-robot interaction, while the latter can accurately learn for gravity compensation. The right-arm robot is used as a robot-assisted surgical tool, providing virtual fixture (VF) assistance and haptic feedback during the surgery. The right-arm robot is implemented with a point-based VF algorithm, which can generate VF directly from point clouds in any shape, render force feedback, and deliver it to the operator. Furthermore, the VF, the bone, and the surgical tool position are visualized in a 3D digital environment as additional visual feedback for the operator. A series of experiments are conducted to evaluate the effectiveness of the prototype. The results demonstrate that both arms can provide satisfactory assistance as designed.
... Robot-assisted surgeries are transforming traditional orthopedic surgeries by helping surgeons achieve more successful and precise surgical outcomes with the assistance of robots [2]- [4]. Elbow arthroscopy is a typical type of MIS in orthopedics that allows the management of elbow stiffness, arthritis, and fractures in a minimally invasive fashion [5]. During traditional elbow arthroscopy, the surgeon needs to hold an arthroscope with one hand while performing the surgical operations with the other hand, which can restrict the dexterity of the surgical performance and increase the cognitive load. ...
Robot-assisted arthroscopic surgery has been increasingly receiving attention in orthopedic surgery. To build a robot-assisted system, dynamic uncertainties can be a critical issue that could bring robot performance inaccuracy or even system instability if cannot be appropriately compensated. Disturbance observer is a common tool to be used for disturbance estimation and compensation by taking all uncertainties as disturbances, but this will refuse human–robot interaction since the human-applied force will also be regarded as a disturbance by the observer. Iterative learning for gravity compensation can be another promising way to solve this problem when gravity compensation is the main concern. In this article, a gravity iterative learning (Git) scheme in Cartesian space for gravity compensation, integrating with an impedance controller, is presented. A steady-state scaling strategy is then proposed, which released the updating requirements of the learning scheme and also extended its validity to trajectory-tracking scenarios from set-point regulations. The deriving process and convergence properties of the Git scheme are presented and theoretically analyzed, respectively. A series of simulations and physical experiments are conducted to evaluate the validity of the scaling strategy, the learning accuracy of the Git scheme, and the effectiveness of the learning-based impedance controller. Both simulation and experimental results demonstrate good performance and properties of the Git scheme and the learning-based impedance controller.
... 25 This was the first time it was realized that endoscopy could be used to detect early musculoskeletal defects. 3 In 1931, however, an article was published claiming that the elbow was unsuitable for examination with an arthroscope because the "needle" was too large for the small joint space (Fig. 8). 32 This report put a stop to the growing interest in elbow arthroscopy. ...
The origins of contemporary orthopedics can be traced all the way back to antiquity. Despite the absence of modern imaging techniques, a few bright minds were able to lay the groundwork for understanding these fractures. This historical review will cover the process behind the various treatments for elbow fractures, such as splinting and casting, mobilization, amputation, fracture fixation, arthroplasty, and arthroscopy.
... Elbow arthroscopy is a novel and complex procedure that allows management of elbow stiffness, arthritis and fractures in a minimally fashion [1]. Minimally invasive surgery (MIS) has been gaining popularity due to its potential benefits of faster recovery time and decreased pain [2]. ...
... where M ∈ R n×n denotes the inertia matrix, S ∈ R n×n denotes a matrix related to the Coriolis and centrifugal forces, g ∈ R n represents a gravity-related vector, τ ∈ R n is the commanded joint torque vector, F ext ∈ R 6 is the external force in Cartesian space, and J ∈ R 6×n is the Jacobian matrix. Note that friction is not included in (1). A full impedance model [16], [17] for robot-environment contact can be expressed as ...
... A circle tracking task in free space is employed and the circle trajectory is given by (12). This condition is performed by implementing the 1 impedance control law V2 and NDOB, i.e., the Scenario 2 given by (10). Four cases are designed for this condition: Fig. 2. Note that no dynamic model inaccuracy is involved in the simulations, which means that the only dynamic uncertainty is the external disturbance of the constant payload. ...
Robot-assisted arthroscopic surgery is transforming the tradition in orthopaedic surgery. Compliance and stability are essential features that a surgical robot must have for safe physical human-robot interaction (pHRI). Surgical tools attached at the robot end-effector and human-robot interaction will affect the robot dynamics inevitably. This could undermine the utility and stability of the robotic system if the varying robot dynamics are not identified and updated in the robot control law. In this paper, an integrated framework for robot impedance control and nonlinear disturbance observer (NDOB)-based compensation of uncertain dynamics is proposed, where the former ensures compliant robot behavior and the latter compensates for dynamic uncertainties when necessary. The combination of impedance controller and NDOB is analyzed theoretically in three scenarios. A complete simulation and experimental studies involving three common conditions are then conducted to evaluate the theoretical analyses. A preliminary pHRI application on arthroscopic surgery is designed to implement the proposed framework on a robotic surgeon-assist system and evaluate its effectiveness experimentally. By integrating impedance controller with NDOB, the proposed framework allows an accurate impedance control when dynamic model inaccuracy and external disturbance exist.
