Zhang Ling, Hu Hansheng, Huang Wennuo, Hu Mengling, Li Zhuman, Zhao Jinzhong, Fei Wenyong, Wang Shaobai
School of Exercise and Health, Shanghai University of Sport, 200 Hengren Road, Shanghai 200438, China.
Department of Orthopedics and Sports Medicine, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, 98 Nantong West Road, Yangzhou 225001, China.
Bioengineering (Basel). 2025 Mar 24;12(4):338. doi: 10.3390/bioengineering12040338.
The anatomic characteristics of the graft and tunnel, i.e., the tunnel position, angle, length, and the graft bending angle, influence knee joint stability and postoperative functional recovery. The purpose of this study was to evaluate the tunnel position, length and angle, as well as graft bending angle after ACL reconstruction assisted by a surgical robot. A total of 70 patients were randomized into two groups: the surgical robot group (robot group, = 35) and the traditional handheld locator group (control group, = 35). Postoperative computed tomography (CT) was employed to assess the positions and lengths of the tunnels, as well as the tunnel angle and the graft bending angle. Additionally, the posterior wall distance was measured by determining the minimum vertical distance from the long axis of the tunnel to the posterior wall region. There were no significant differences between the two groups in the mean position or length of the femoral and tibial tunnel ( > 0.05). However, the femoral tunnel angle was significantly larger in the robot group compared to the handheld locator group ( = 0.012). The graft bending angle was significantly less acute in the robot group than in the control group ( = 0.008). Additionally, the posterior wall distance was significantly greater in the robot group compared to the control group ( < 0.001). The results suggest that surgical robot-assisted ACL reconstruction enhances safety in the inclination of the tunnel and graft, helping to avoid potential biomechanical issues such as the wiper effect and the bungee effect, which may lead to tunnel widening and surgical failure.
移植物和骨隧道的解剖学特征，即隧道位置、角度、长度以及移植物的弯曲角度，会影响膝关节稳定性和术后功能恢复。本研究的目的是评估在手术机器人辅助下前交叉韧带重建术后的隧道位置、长度和角度，以及移植物的弯曲角度。总共70例患者被随机分为两组：手术机器人组（机器人组，n = 35）和传统手持定位器组（对照组，n = 35）。术后采用计算机断层扫描（CT）评估隧道的位置和长度，以及隧道角度和移植物弯曲角度。此外，通过测定隧道长轴到后壁区域的最小垂直距离来测量后壁距离。两组在股骨和胫骨隧道的平均位置或长度方面无显著差异（P>0.05）。然而，机器人组的股骨隧道角度明显大于手持定位器组（P = 0.012）。机器人组移植物的弯曲角度明显比对照组小（P = 0.008）。此外，机器人组的后壁距离明显大于对照组（P<0.001）。结果表明，手术机器人辅助的前交叉韧带重建可提高隧道和移植物倾斜度的安全性，有助于避免诸如雨刮器效应和蹦极效应等可能导致隧道扩大和手术失败的潜在生物力学问题。
