Superior accuracy of femoral bone tunnel drilling in robot-assisted anterior cruciate ligament reconstruction: a multicenter, randomized, controlled trial

Abstract

PURPOSE: To assess the efficacy and safety for bone tunnel drilling in anatomic anterior cruciate ligament (ACL) reconstruction with the assistance of a surgical navigation robot system. METHODS: A total of 79 patients were randomized to either surgical navigation robot group (robot group, n = 39) or traditional handheld locator group (control group, n = 40). The robot group underwent anatomic ACL reconstruction using a surgical navigation robot, while the control group underwent the procedure using a traditional handheld locator. Postoperative three-dimensional computed tomography was used to measure the tibial and femoral tunnel position, as well as the tibial and femoral tunnel length. The success rate of femoral tunnel positioning was defined as the proportion of cases in which the femoral tunnel was placed accurately within the ideal anatomical position. RESULTS: The success rate of femoral tunnel positioning in the robot group was significantly higher than that in the control group (82.1% vs 50%, P = 0.003). The surgical time in the robot group was significantly longer than that in the control group (122.8 min ± 34.9 min vs 84.0 min ± 28.3 min, P = 0.05). The incidence rate of adverse events did not show statistical significance between the two groups ( P = 0.830). There were no adverse events associated with the instruments or any serious adverse events, and no patients withdrew from the trial due to adverse events. CONCLUSIONS: The success rate for femoral tunnel positioning in anatomic ACL reconstruction was higher with surgical navigation robots compared to the traditional handheld locator. Surgical navigation robot systems are safe tools in anatomic ACL reconstruction surgery.