International Orthopaedics ( IF 2.7 ) Pub Date : 2022-09-28 , DOI: 10.1007/s00264-022-05592-x Liang Zhang 1 , Qiuzhen Liang 1 , Zandong Zhao 1 , Li Zhang 2 , Xin Kang 1 , Bin Tian 1 , Bo Ren 1 , Xian Zhang 1 , Zijun Gao 2 , Yue Wang 1 , Jiang Zheng 1
Purpose
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.
Methods
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.
Results
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.
Conclusions
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.
中文翻译:
骨骼未成熟患者的机器人辅助全骨骺前交叉韧带重建:一项回顾性研究
目的
回顾一系列采用机器人辅助全骨骺 ACL 重建术(ACLR)手术治疗前交叉韧带(ACL)损伤的青少年患者,并与传统徒手组进行比较。
方法
本回顾性临床研究纳入了 2018 年 6 月至 2020 年 3 月通过机器人辅助技术或传统徒手方法进行 ACLR 手术的 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)。患者)。记录两组术中透视次数、手术时间、骨隧道置入准确度、国际膝关节文献委员会(IKDC)主观评分及韧带松弛度检测结果。
结果
所有患者在术后平均 31.6 ± 4.5 个月返回接受随访。机器人辅助组的平均年龄为 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,差异有统计学意义( P < 0.05 ) 。机器人辅助组手术时间短于传统徒手组(87±10.7 min vs. 126±12.1 min,P < 0.05)。机器人辅助组股骨和胫骨关节内骨隧道的实际插入中心与理想插入中心之间的距离分别为1.5±0.3mm和1.6±0.3mm,2.7mm±0.4mm和2.4± 0.4mm为传统写意组(P < 0.05)。末次随访时两组功能恢复无明显差异。
结论
全骨骺 ACLR 是一项技术要求很高的手术,误差很小。机器人辅助治疗骨骼未成熟患者ACL损伤比传统的徒手方法更准确,手术时间更短,术中透视更少。