Objective  To compare the effectiveness of arthroscopy-assisted and orthopaedic robot-assisted techniques in the treatment of Rockwood type Ⅲ and Ⅳ acute acromioclavicular dislocation. Methods The clinical data of 33 patients with acromioclavicular dislocation who were treated with titanium plate with loop fixation between October 2022 and December 2024 and met the selection criteria were retrospectively analyzed. The patients were divided into robot group (17 cases) and arthroscopy group (16 cases) according to the different ways of assisted surgery. There was no significant difference in baseline data between the two groups (P>0.05), such as gender, age, cause of injury, side, Rockwood classification, time from injury to operation, and preoperative visual analogue scale (VAS) score, Constant-Murley score, coracoclavicular distance (CCD). The operation time, intraoperative blood loss, total length of incision, intraoperative fluoroscopy frequency, changes of VAS score at 1 day after operation (compared with those before operation), and complications were recorded and compared between the two groups, and the degree of acromioclavicular joint separation was evaluated by CCD measurement on three-dimensional CT coronal plane at 2 days and 6 months after operation. The accuracy of the clavicular and coracoid drilling position was evaluated at 2 days after operation. Constant-Murley score was used to evaluate the function of the shoulder joint before operation and at 1 and 6 months after operation. Results The incisions of the two groups healed by first intention. The operation time, intraoperative blood loss, total length of incision, and the change of VAS score at 1 day after operation in the robot group were significantly less than those in the arthroscopy group (P<0.05), and the intraoperative fluoroscopy frequency in the robot group was significantly more than that in the arthroscopy group (P<0.05). Patients in both groups were followed up 6-12 months, with an average of 10.15 months. At 2 days after operation, digital radiography showed that the acromioclavicular joint had been reduced. The CCD at 2 days and 6 months after operation were significantly lower than those before operation, and the CCD at 6 months after operation was significantly higher than that at 2 days after operation (P<0.05). There was no significant difference in CCD between the two groups at two time points after operation (P>0.05). There was no significant difference in the accuracy of clavicular drilling position between the two groups at 2 days after operation (P>0.05); the accuracy of coracoid drilling position in the robot group was significantly lower than that in the arthroscopy group (P<0.05). There was no complication such as vascular and nerve injury, coracoid process fracture, or redislocation in both groups. Constant-Murley scores at 1 and 6 months after operation were significantly higher than those before operation, and that at 6 months after operation was higher than those at 1 month after operation, and the differences were all significant (P<0.05). The Constant-Murley score of the robot group was significantly higher than that of the arthroscopy group at 1 month after operation (P<0.05), and there was no significant difference between the two groups at 6 months after operation (P>0.05). Conclusion Both assisted techniques of internal fixation with titanium plate with loop can achieve good effectiveness in the treatment of acromioclavicular dislocation. Robot assisted surgery has advantages in incision length, intraoperative blood loss, postoperative VAS score, and early postoperative shoulder joint function, but arthroscopic assisted surgery has advantages in intraoperative fluoroscopy frequency and accuracy of coracoid drilling.

Citation： CHEN Lei, LI Longfu, YUAN Yucheng, GUO Wenbo. Comparative study of orthopaedic robot-assisted and arthroscopy-assisted treatment of Rockwood type Ⅲ and Ⅳ acute acromioclavicular dislocation. Chinese Journal of Reparative and Reconstructive Surgery, 2026, 40(2): 241-247. doi: 10.7507/1002-1892.202508063 Copy

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