Zhang Liang, Liang Qiuzhen, Zhao Zandong, Zhang Li, Kang Xin, Tian Bin, Ren Bo, Zhang Xian, Gao Zijun, Wang Yue, Zheng Jiang
Sports Medicine Center, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, 710054, China.
Anesthesiology Department, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, 710054, China.
Int Orthop. 2023 Feb;47(2):429-435. doi: 10.1007/s00264-022-05592-x. Epub 2022 Sep 28.
To review a series of adolescent patients with anterior cruciate ligament (ACL) injuries surgically treated with robot-assisted all-epiphyseal ACL reconstruction (ACLR), and to compare with the traditional freehand group.
This retrospective clinical study included 16 patients with ACL injuries who underwent ACLR by robot-assisted technique or traditional freehand method from June 2018 to March 2020. All patients were divided into the robot-assisted group (6 patients) or the traditional surgery group (10 patients). The number of intra-operative fluoroscopies, operation time, accuracy of bone tunnel insertions, International Knee Documentation Committee (IKDC) subjective score and ligament laxity testing were recorded in the two groups.
All patients returned for follow-up, at a mean of 31.6 ± 4.5 months after surgery. The average age of the robot-assisted group was 12.2 ± 1.3 years. The number of intra-operative fluoroscopies was 10.9 ± 2.8 in the traditional freehand group, whereas it was only 3.0 ± 0.6 in the robot-assisted group, which was significantly lower (P < 0.05). The operative time in the robot-assisted group was shorter than that in the traditional freehand group (87 ± 10.7 min vs. 126 ± 12.1 min, P < 0.05). The distance between the center of actual insertion and the center of the idea insertion on both femoral and tibial intra-articular bone tunnel were 1.5 ± 0.3 mm and 1.6 ± 0.3 mm for the robot-assisted group and 2.7 mm ± 0.4 mm and 2.4 ± 0.4 mm for the traditional freehand group (P < 0.05). There were no significant differences between the two groups in function recovery at the last follow-up.
All-epiphyseal ACLR is a technically demanding procedure with a small margin of error. Robot-assisted treatment of ACL injuries in skeletally immature patients is more accurate than traditional freehand method, with shorter operation time and fewer intra-operative fluoroscopies.
回顾一系列接受机器人辅助全骨骺前交叉韧带重建术（ACLR）治疗的青少年前交叉韧带（ACL）损伤患者，并与传统徒手手术组进行比较。
这项回顾性临床研究纳入了2018年6月至2020年3月期间通过机器人辅助技术或传统徒手方法接受ACLR的16例ACL损伤患者。所有患者分为机器人辅助组（6例）或传统手术组（10例）。记录两组患者术中透视次数、手术时间、骨隧道置入的准确性、国际膝关节文献委员会（IKDC）主观评分和韧带松弛度测试结果。
所有患者均进行了随访，平均随访时间为术后31.6±4.5个月。机器人辅助组患者的平均年龄为12.2±1.3岁。传统徒手组术中透视次数为10.9±2.8次，而机器人辅助组仅为3.0±0.6次，明显更低（P<0.05）。机器人辅助组的手术时间短于传统徒手组（87±10.7分钟对126±12.1分钟，P<0.05）。机器人辅助组股骨和胫骨关节内骨隧道实际置入中心与理想置入中心之间的距离分别为1.5±0.3毫米和1.6±0.3毫米，传统徒手组分别为2.7±0.4毫米和2.4±?0.4毫米（P<0.05）。末次随访时两组功能恢复情况无显著差异。
全骨骺ACLR是一项技术要求高、误差 margin小的手术。机器人辅助治疗骨骼未成熟患者的ACL损伤比传统徒手方法更准确，手术时间更短，术中透视次数更少。
