Anterior cruciate ligament (ACL) reconstruction is performed using the preoperative navigation of Naton Robotics, followed by random assignment to either robotic surgery or traditional manual surgery. The difference between the two lies in whether the localization of the ACL footprint is performed by a human or by the robotic arm. The surgical technique is standardized as double-bundle reconstruction.

At preoperative, 6 weeks postoperative, 3 months postoperative, 12 months, and 24 months, researchers measure the anterior translation distance of the tibia for both the affected and healthy knee joints of the participants. Each side is measured three times, and the average of these three measurements is taken as the final measurement value for the anterior translation distance of the tibia. The relative anterior translation distance is calculated as the affected tibial anterior translation distance minus the healthy tibial anterior translation distance. Measurements are performed using the Kneelaxity arthrometer.

Kneelaxity arthrometer is a device used to assess knee joint stability by measuring the anterior translation of the tibia relative to the femur, providing objective data on knee laxity and aiding in the evaluation of knee injuries and surgical outcomes.

At preoperative, 6 weeks postoperative, 3 months postoperative, 12 months, and 24 months, researchers use a goniometer to measure the flexion and hyperextension angles of the affected knee joint. Each angle is measured three times, and the average of these three measurements is taken as the final measurement value for each angle.

At preoperative, 6 weeks postoperative, 3 months postoperative, 12 months, and 24 months, researchers assess the IKDC score for the affected knee joint of each participant. Responses to each item are scored using an ordinal scale, where the answer representing the lowest functional level or highest symptom level receives 0 points. For example, the first item relates to performing the highest level of activity without significant pain; if the response is "I cannot perform any of the above activities due to knee pain," it receives 0 points; if the response is "very vigorous activities, such as jumping or rotating in basketball or soccer games," it also receives 0 points. The second item pertains to the frequency of pain over the past four weeks, where "constant pain" receives 0 points and "no episodes" receives 10 points.

The scoring method for the IKDC subjective knee function evaluation form involves summing the scores of the above items (the 10th item, "What was your knee function b

The researchers assess the Tegner Knee Activity Scale for the affected knee joint of each participant at preoperative, 6 weeks postoperative, 3 months postoperative, 12 months, and 24 months.

Tegner Knee Activity Scale is a scoring system used to evaluate knee function and activity level. The scale scores patients based on the intensity of various activities they have been able to perform over a specific period. The score ranges from 0 to 10, where 0 indicates the inability to perform any activities, and 10 indicates the ability to engage in high-intensity sports, such as competitive-level activities. The Tegner score helps clinicians understand the functional status of the patient's knee and its impact on daily life and sports activities.

The researchers assess the VAS pain score for each participant at preoperative, 1 week postoperative, 6 weeks postoperative, 3 months postoperative, 12 months, and 24 months, and calculate the improvement rate of the VAS score at 1 week, 6 weeks, and 3 months postoperative.

Visual Analog Scale (VAS) is a subjective scale used to assess pain intensity. The VAS typically consists of a horizontal or vertical line, usually 10 centimeters long, with endpoints labeled "no pain" (0 points) and "worst imaginable pain" (10 points). Patients score their pain intensity by marking a point on this line.