Robotic-assisted vs. traditional medial patellofemoral ligament reconstruction: a comparative study of surgical precision and clinical outcomes.

Abstract

Purpose: To evaluate the feasibility and clinical effectiveness of reconstructing the Medial Patellofemoral Ligament (MPFL) using robotic-assisted reconstruction.

Methods: This retrospective cohort study encompassed 46 patients who underwent medial patellofemoral ligament reconstruction at Yichang People's Hospital between January 2022 and January 2024. Patients were categorized into a conventional surgery group (control group, n = 24) and a robot-assisted surgery group (experimental group, n = 22) based on whether robotic assistance was used during the procedure. The primary endpoints included the error margin between the femoral tunnel entry point, a predefined reference landmark, and the quantity of intraoperative fluoroscopic exposures. Secondary endpoints consisted of knee function scores at postoperative and final follow-up evaluations, patellar stability, operative duration, length of hospital stay, and intraoperative blood loss.

Results: The experimental group demonstrated a significantly higher degree of precision in femoral tunnel placement than the control group, as indicated by a smaller mean distance from the tunnel entry point to the reference landmark (P < 0.05). Additionally, the experimental group markedly reduced intraoperative fluoroscopic exposures relative to the control group (P < 0.05). No significant differences were observed between the two groups regarding postoperative or final follow-up patellar stability or knee function scores (P > 0.05). Furthermore, the experimental group incurred significantly shorter hospital stays and experienced less intraoperative blood loss than the control group (P < 0.05). At the same time, the operative time did not present any significant differences between groups (P > 0.05).

Conclusion: Robot-assisted MPFL reconstruction significantly enhances femoral tunnel positioning accuracy and surgical efficiency compared to conventional methods. This approach offers a promising surgical option for improving precision and efficiency in the management of recurrent patellar dislocation, with potential implications for future research.