[Efficacy and reproducibility of a novel robotic-assisted system for anterior cruciate ligament reconstruction in in vitro bone tunnel drilling].

Abstract

Objective: To quantitatively evaluate the efficacy, precision, and reproducibility of the surgical navigation module of a novel robotic-assisted anterior cruciate ligament reconstruction (ACLR) system during bone tunnel drilling using in vitro models. Methods: Thirty 3D-printed knee models were randomized into a robotic group (n=15) and a conventional group (n=15) using a random number table. Both groups utilized the same individualized surgical plans generated by the system's preoperative planning module. In the robotic group, bone tunnel drilling was guided by the system's mechanical arm; in the conventional group, drilling was performed manually by senior sports medicine surgeons using traditional instrumentation. Operative time was recorded. Postoperative bone tunnel lengths and tunnel exit positions in both groups were compared with the preoperative planning values among the three groups. Results: The total operative time was significantly longer in the robotic group [(25.83±2.20) vs (15.55±1.96) min, P<0.001], whereas the robotic group achieved a significantly shorter duration for the core bone tunnel drilling phase [6.08 (5.72, 6.75) vs 7.60 (6.80, 8.52) min, P=0.003]. There were no statistically significant differences among the three groups regarding the numerical values of the three length indicators (femoral and tibial tunnel lengths, intra-articular distance) or the four tunnel exit position dimensions (deep-shallow, high-low, anterior-posterior, medial-lateral) within the Bernard quadrant (all P>0.05). However, the variance in all positioning dimensions was significantly lower in the robotic group compared to the conventional group (all P<0.05), particularly in the femoral high-low and tibial anterior-posterior directions (both P<0.001), indicating superior consistency in robot-assisted operation. Conclusions: Robot-assisted ACLR technology improves efficiency during the critical drilling phase and significantly minimizes manual operational variability. These findings provide experimental evidence supporting the application of high-precision surgical navigation in ACLR.