A comparative study of tunnel placement accuracy in robotic-assisted versus traditional combined anterior and posterior cruciate ligament reconstruction.

This study developed a new surgical robot for cruciate ligament reconstruction and compared its accuracy of bone tunnel placement with traditional surgical methods in combined posterior cruciate ligament (PCL) and anterior cruciate ligament (ACL) reconstruction. 8 human cadaver knees were used for robot-assisted combined PCL and ACL reconstruction, and three-dimensional (3D) computed tomography (CT) was performed after operation to confirm the bone tunnel information. Postoperative 3D CT images of eight patients completed by the same operator with conventional techniques were also acquired. The operation time, bone tunnel position and length were measured and compared between robotic and conventional surgery. Regarding the tunnel position, there was no significant difference between the planned and actual tunnels in robotic surgery and the anatomical site of the cruciate ligament (P > 0.05). However, there are significant differences between robotic and conventional surgery (P < 0.001). Compared with traditional surgery, the robotic surgery demonstrated higher accuracy in the drilling of the cruciate ligament tunnel. Regarding the length of the cruciate ligament tunnel, no statistically significant discrepancy was observed between the actual and planned tunnels (P > 0.05), with a maximum error of less than 2 mm. The robot was able to accurately control the length of the cruciate ligament tunnel. The robots can be used to assist in combined ACL and PCL reconstruction with higher accuracy than traditional surgery. It is a potentially powerful tool to enhance cruciate ligament reconstruction surgery.