前交叉韧带重建骨道导航的演进△（开放获取）

Evolution of bone tunnel navigation for anterior cruciate ligament reconstruction

摘要:

前交叉韧带重建 （anterior cruciate ligament reconstruction, ACLR） 是治疗前交叉韧带 （anterior cruciate ligament, ACL）断裂的金标准手术，但传统骨道定位方法依赖医生经验，准确性和可重复性较低，导致较高的翻修率。近年来，导航技术在 ACLR 手术骨道定位中的应用取得了显著进展，导航技术从主动光学导航到基于 CT、MRI 及多模态影像融合不断发展， 显著提升了股骨隧道和胫骨隧道的定位精准度，提高解剖学准确性，但短期临床效果与传统方法差异不显著，长期效果仍需进一步验证。导航通过减少人为误差，提升了手术稳定性和安全性，但其高成本、操作复杂性和侵入性增强等缺点限制了广泛应用。本文综述了前交叉韧带重建骨道导航国内外技术发展、临床应用进展、未来可能的发展方向。

Abstract:

Anterior cruciate ligament reconstruction (ACLR) is the gold standard for the treatment of anterior cruciate ligament rupture, but the traditional bone tunnel positioning method relies on the doctor's experience, with low accuracy and repeatability, resulting in a high revision rate. In recent years, the application of navigation technology in bone tunnel positioning in ACLR surgery has made significant progress. Navigation technology has continuously developed from active optical navigation to CT, MRI and multi-modal image fusion, which has significantly improved the positioning accuracy of femoral and tibial tunnels in anatomy. However, its short-term clinical consequence is not significantly different from the traditional method, and the long-term outcome still needs to be further verified. Navigation improves surgical reliability and safety by reducing personal equation, whereas its high cost, operational complexity and increased invasiveness limit its widespread application. This article reviewed the domestic and international technical development, clinical application progress and possible future development direction of bone tunnel navigation for anterior cruciate ligament reconstruction.