Observational studyJournal of robotic surgery2025
Robotic-assisted navigation with patient-specific implants vs. modified Stoppa and MIPPO in Tile C pelvic fractures: a multicenter cross-sectional observational study with osteoporosis subgroup analysis.
Observational study in Journal of robotic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Emerging Technologies for Assisted Fracture Reduction: A Systematic Review.Annals of biomedical engineering · 2026Review
- Global research hotspots and emerging trends in orthopedic robotic surgery: a comprehensive bibliometric analysis.Journal of robotic surgery · 2026Review
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Authors and funding
7 authors.
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Abstract
Tile C pelvic fractures present significant therapeutic challenges, especially in obese and osteoporotic patients, where traditional techniques (Modified Stoppa approach, minimally invasive percutaneous plate osteosynthesis [MIPPO]) are limited by poor precision and high complication rates. Robotic-assisted navigation (RAN) with patient-specific implants (PSI) may improve outcomes, but gaps remain in understanding its performance in multicenter settings (e.g., surgeon skill variability), nonlinear BMI effects on functional recovery, and cost-effectiveness stratified by BMI-bone mineral density (BMD) interactions. This study aimed to compare RAN + PSI with traditional methods in operative efficiency, functional outcomes, and cost-effectiveness, while addressing multicenter bias and validating the optimal BMI for functional recovery. This was a multicenter prospective observational cohort study conducted at tertiary trauma centers in China (January 2022-2025), enrolling 220 patients with Tile C pelvic fractures. Patients were stratified by center and fracture subtype (Tile C1/C3) before allocation to three groups: RAN + PSI (n = 110), Modified Stoppa (n = 55), and MIPPO (n = 55)-this stratification minimized bias from intercenter surgeon skill differences and uneven case distribution. For RAN + PSI, preoperative CT scans generated 3D pelvic reconstructions to design custom implants and plan screw trajectories; intraoperative robotic calibration (TianJi Robot system) ensured submillimeter precision. Traditional techniques followed standardized protocols (Modified Stoppa: open anterior pelvic exposure with precontoured plates; MIPPO: fluoroscopy-guided percutaneous plate/screw placement). Primary outcomes included Matta reduction grade, Majeed Pelvic Score (12 months), and cost-effectiveness (incremental cost-effectiveness ratio [ICER], Chinese RMB/quality-adjusted life-year [QALY]). Polynomial regression modeled nonlinear BMI effects, and stratified analyses validated BMI-BMD interactions. RAN + PSI outperformed traditional methods in key metrics: (1) Implant precision: mean deviation 1.2 ± 0.5 mm vs. 2.7 ± 1.1 mm (Modified Stoppa) and 2.4 ± 0.9 mm (MIPPO, p < 0.001); (2) Operative efficiency: 98 ± 22 min vs. 145 ± 35 min (Modified Stoppa) and 138 ± 30 min (MIPPO, p < 0.001); (3) Complications: 10% vs. 25.5% (Modified Stoppa) and 23.6% (MIPPO, p = 0.003). Polynomial regression identified a peak Majeed Score (89.2 ± 5.8) at BMI ~ 26.5 kg/m
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