Liao Chaofan, Zheng Jiang, Liang Qiuzhen, Liu Peidong, Pang Panpan, Zhang Liang
Graduate School, Xi'an Medical University, Xi'an, China.
Sports Medicine Center, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.
Front Surg. 2025 Jun 26;12:1595715. doi: 10.3389/fsurg.2025.1595715. eCollection 2025.
There is limited research worldwide on posterior cruciate ligament (PCL) tears in pediatric and adolescent patients (PAPs). This report aims to present our treatment method as a potential reference for clinical surgery.
We report the case of a 13-year-old boy with a PCL tear who underwent robot-assisted arthroscopic all-epiphyseal PCL reconstruction (PCLR) with remnant preservation using the TiRobot surgical robot. The patient was followed for 6 months postoperatively.
The surgery lasted 110 min, involving four x-ray exposures and a single guide pin insertion, without requiring positional adjustment. Postoperative magnetic resonance imaging on day 2 confirmed that the femoral and tibial bone tunnels were within the epiphysis, with good graft fixation. The angle between the reconstructed tibial bone tunnel and the graft was approximately 104.1°. Sutures were removed after 2 weeks, showing good wound healing and full extension of the affected limb. By 8 weeks, the patient had regained full knee flexion, and by 12 weeks, muscle strength of the affected limb exceeded 85% of that in the contralateral side, allowing the patient to start jogging. By 16 weeks, the patient resumed badminton training. At the last follow-up, knee function had markedly improved, with the preoperative International Knee Documentation Committee score increasing from 43.68 to 82.76 and the Lysholm score increasing from 46 to 95.
Arthroscopic all-epiphyseal PCLR with remnant preservation, assisted by the TiRobot orthopedic robot navigation system, demonstrated several clinical advantages. The technique theoretically avoids damage to the PAPs' growth plate, preserves the PCL remnants, reduces the "killer turn" effect, and minimizes the risk of injury to surrounding blood vessels and nerves. Serial radiographic evaluations during the 6-month follow-up revealed no evidence of physeal damage in this case.
全球范围内关于儿童和青少年患者（PAPs）后交叉韧带（PCL）撕裂的研究有限。本报告旨在介绍我们的治疗方法，为临床手术提供潜在参考。
我们报告了一例13岁PCL撕裂男孩的病例，该患者使用TiRobot手术机器人接受了机器人辅助关节镜下全骨骺PCL重建（PCLR）并保留残端。术后对患者进行了6个月的随访。
手术持续110分钟，包括4次X线曝光和1次导针插入，无需进行位置调整。术后第2天的磁共振成像证实股骨和胫骨骨隧道位于骨骺内，移植物固定良好。重建的胫骨骨隧道与移植物之间的角度约为104.1°。2周后拆线，伤口愈合良好，患侧肢体完全伸直。到8周时，患者已恢复全膝关节屈曲，到12周时，患侧肢体肌肉力量超过对侧的85%，患者开始慢跑。到16周时，患者恢复了羽毛球训练。在最后一次随访时，膝关节功能明显改善，术前国际膝关节文献委员会评分从43.68提高到82.76，Lysholm评分从46提高到95。
在TiRobot骨科机器人导航系统辅助下，关节镜下全骨骺PCLR并保留残端显示出多种临床优势。该技术理论上避免了对PAPs生长板的损伤，保留了PCL残端，减少了“致命转弯”效应，并将周围血管和神经损伤的风险降至最低。6个月随访期间的系列影像学评估显示，该病例无骨骺损伤迹象。
