Zhang Zi, Meng Binyang, Li Wenhe, Cao Jiangang
Department of Sports Injury and Arthroscopy, Tianjin Hospital, Tianjin University, Tianjin, 300222, People's Republic of China.
Medical School of Tianjin University, Tianjin University, Tianjin, China.
J Robot Surg. 2025 Feb 28;19(1):90. doi: 10.1007/s11701-025-02254-z.
In the past decade, navigation technology-assisted bone tunnels positioning for anterior cruciate ligament reconstruction (ACLR) has received great attention. The purpose of this review is to summarize the navigation technologies applied in ACLR, describe the tunnel positioning accuracy of these technologies, and summarize their advantages and disadvantages, providing a basis for navigation technology to assist ACLR. This review discusses the limitations of traditional bone tunnel positioning methods in ACLR and further introduces various navigation techniques, focusing on their positioning accuracy and postoperative outcomes for patients. Additionally, it presents commercial systems utilizing reality-based technologies and examines their impact on the arthroscopic learning curve for less experienced surgeons. The osseous landmarks are currently the most used positioning method, but they still have shortcomings. Navigation technologies primarily focus on computer-assisted navigation, which, however, requires additional incisions. Virtual reality and augmented reality are mainly utilized in preoperative planning, with the best-reported positioning accuracy of augmented reality being 0.32 mm, while most other accuracies are within 3 mm. Mixed reality offers a novel approach for precise positioning, resulting in more optimal and consistent postoperative tunnel placement. Navigation technology improves the positioning accuracy of the bone tunnels and achieves good short-term results. Key to the future is long-term follow-up to assess clinical outcomes of navigation techniques.
在过去十年中，导航技术辅助下的前交叉韧带重建（ACLR）骨隧道定位受到了广泛关注。本综述的目的是总结应用于ACLR的导航技术，描述这些技术的隧道定位准确性，并总结其优缺点，为导航技术辅助ACLR提供依据。本综述讨论了ACLR中传统骨隧道定位方法的局限性，并进一步介绍了各种导航技术，重点关注其定位准确性和患者的术后结果。此外，还介绍了利用基于现实技术的商业系统，并考察了它们对经验不足的外科医生关节镜学习曲线的影响。目前，骨性标志是最常用的定位方法，但仍存在缺点。导航技术主要集中在计算机辅助导航，然而这需要额外的切口。虚拟现实和增强现实主要用于术前规划，报道的增强现实最佳定位精度为0.32毫米，而大多数其他精度在3毫米以内。混合现实为精确定位提供了一种新方法，可使术后隧道放置更加优化和一致。导航技术提高了骨隧道的定位准确性，并取得了良好的短期效果。未来的关键是进行长期随访，以评估导航技术的临床结果。
