Clinical advantages of image-free navigation system using surface-based registration in anatomical anterior cruciate ligament reconstruction

Abstract

Navigation systems with enhancement of the registration accuracy by the developed system are feasible in anatomical ACLR, in reducing surgical failures such as short tunnel length or posterior wall breakage of distal femur. The present study revealed that computer navigation could aid in avoiding major mistakes in exact positioning and posterior wall blowout and help in attaining appropriate length for femoral tunnelling in anatomical ACLR.

Accuracy of the femoral tunnel position in robot‐assisted anterior cruciate ligament reconstruction using a magnetic resonance imaging‐based navigation system: A preliminary report

“…The navigation system used for ACL reconstruction is mainly based on fluoroscopy or a CT scan . However, such systems often require additional study.…”

“…Lee et al . evaluated the positioning of the femoral tunnel in cadavers using a CT‐based navigation system . They reported a satisfactory accuracy for anatomic ACL reconstruction using a computer‐assisted navigation system and could reduce surgical failures such as short tunnel length or posterior wall breakage of the distal femur.…”

“…The navigation system used for ACL reconstruction is mainly based on fluoroscopy 6,12,13 or a CT scan. [7][8][9]14 However, such systems often require additional study. On the other hand, MRI was performed before surgery in most patients who underwent ACL reconstruction.…”

“…A navigation system improves the accuracy of the femoral tunnel position during ACL reconstruction. There have been several studies on ACL reconstruction using a navigation system, [6][7][8][9][10][11][12][13][14] and they reported good results for the accuracy and reproducibility of the tunnel position. Furthermore, robot-assisted surgeries are becoming popular in many fields of orthopaedic surgery, and several studies have reported the results of robot-assisted ACL reconstruction.…”

“…[15][16][17] The purpose of the current study was to develop a surgical robot system for ACL reconstruction to create the femoral tunnel by a magnetic resonance imaging (MRI)-based preoperative planning and navigation system. Several authors have reported on ACL reconstruction using fluoroscopy or a computed tomography (CT)based navigation system, [6][7][8][9][10][11][12][13][14] but there has been no study using an MRI-based navigation system. We hypothesized that a difference of less than 2 mm between the planned femoral tunnel position and the created one was achievable.…”