Computer Assistance in Arthroscopic Anterior Cruciate Ligament Reconstruction

Klos, Tiburtius V S; Habets, Raymond J.E.; Banks, Anne Z.; Banks, Scott; Devilee, Roger J.J.; Cook, Frank F.

doi:10.1097/00003086-199809000-00009

Cited by 102 publications

(56 citation statements)

References 19 publications

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“…Various methods, from conventional guiding instruments to computer navigation and robotic systems, have been developed to help the surgeon position tunnel entrances at the desired location, mostly based on isometry or prevention of notch impingement [38]. The use of computer-assisted systems for femoral tunnel positioning during ACL reconstructions has been shown to improve accuracy [44][45][46][47].…”

Section: Discussionmentioning

confidence: 99%

“…Passive computer-assisted navigation and active roboticassisted surgery systems can contribute to minimizing variation in graft placement. The initial reports on the use of these innovative systems in ACL reconstruction have provided clear evidence that more exact bone tunnel placement relative to the preferred position can be achieved with both passive and active systems than with conventional techniques [40,41,[44][45][46][47].…”

Section: Introductionmentioning

confidence: 99%

“…These are based on two different methods: One method uses images, such as preoperative radiographs [37] and CT [43] or intraoperative fluoroscopic computer overlay techniques [44]; the other method is image-free and uses real-time navigation, which means that structures can be digitized during surgery. With the latter method, the 3D anatomical data of the patient's knee is used to find the preferred graft position.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Development of a femoral template for computer-assisted tunnel placement in anatomical double-bundle ACL reconstruction

Luites

Wymenga

Blankevoort

et al. 2011

Computer Aided Surgery

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Femoral graft placement is an important factor in the success of anterior cruciate ligament (ACL) reconstruction. In addition to improving the accuracy of femoral tunnel placement, Computer Assisted Surgery (CAS) can be used to determine the anatomic location. This is achieved by using a 3D femoral template which indicates the position of the anatomical ACL center based on endoscopically measurable landmarks. This study describes the development and application of this method. The template is generated through statistical shape analysis of the ACL insertion, with respect to the anteromedial (AM) and posterolateral (PL) bundles. The ligament insertion data, together with the osteocartilage edge on the lateral notch, were mapped onto a cylinder fitted to the intercondylar notch surface (n ¼ 33). Anatomic variation, in terms of standard variation of the positions of the ligament centers in the template, was within 2.2 mm. The resulting template was programmed in a computer-assisted navigation system for ACL replacement and its accuracy and precision were determined on 31 femora. It was found that with the navigation system the AM and PL tunnels could be positioned with an accuracy of 2.5 mm relative to the anatomic insertion centers; the precision was 2.4 mm. This system consists of a template that can easily be implemented in 3D computer navigation software. Requiring no preoperative images and planning, the system provides adequate accuracy and precision to position the entrance of the femoral tunnels for anatomical single-or double-bundle ACL reconstruction.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Development of a femoral template for computer-assisted tunnel placement in anatomical double-bundle ACL reconstruction

Luites

Wymenga

Blankevoort

et al. 2011

Computer Aided Surgery

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“…This is a computerized navigation system designed to assist surgeons during knee ligament reconstructions and arthroplasty surgery [62]. It uses kinematic measurements along with bone-morphing technology to determine data on alignment, kinematics and morphologic characteristics of the knee [63].…”

Section: Navigation Systemsmentioning

confidence: 99%

An Extensive Evaluation of Different Knee Stability Assessment Measures: A Systematic Review

Abulhasan

Snow

Anley

et al. 2016

JFMK

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Abstract:Re-injury to a recently rehabilitated or operated knee is a common occurrence that can result in significant loss of function. Knee stability measures have been used to diagnose and assess knee stability before and after rehabilitation interventions. Here, we systematically review the literature and evaluate the different anterior-posterior and rotational knee stability measures currently in use. A computer-assisted literature search of the Medline, CINAHL, EMBASE, PubMed and Cochrane databases was conducted using keywords related to knee stability measures. In a second step, we conducted a manual search of the references cited in these articles to capture any studies that may have been missed in the searched databases. The literature search strategy identified a total of 574 potential studies. After revisiting the titles and abstracts, 34 full-text articles met the inclusion criteria and were included in this review. Most articles compared knee stability measures, whilst other studies assessed their sensitivity and specificity. Several techniques and devices used to measure knee stability are reported in the literature. However, there are only a limited number of quality studies where these techniques and/or devices have been evaluated. Further development and investigation with high quality study designs is necessary to robustly evaluate the existing devices/techniques.

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“…CAS planning reduced intersurgical variance, and the position of the virtual tunnels in both the tibia and femur was not related to the experience level of the surgeon. Klos [35] reported a consecutive series of ACL reconstructions by a single surgeon and found that graft placement variability was significantly reduced when an fluoroscopic-guided CAS system was used. Sati [36] reported on a CAS technique with six surgeons positioning an ACL in a cadaveric knee and found low variance in the positioning of both tunnels.…”

Section: Anterior Cruciate Ligament Reconstructionmentioning

confidence: 99%

Applications of computer navigation in sports medicine knee surgery: an evidence-based review

Young

Safran

Clatworthy³

2013

Curr Rev Musculoskelet Med

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Computer-assisted surgery (CAS) has been investigated in a number of sports medicine procedures in the knee. Current barriers to its widespread introduction include increased costs, duration, and invasiveness of surgery. Randomized trials on the use of CAS in anterior cruciate ligament reconstruction have failed to demonstrate a clinical benefit. Data on CAS use in high tibial osteotomy are more promising; however, long-term studies are lacking. CAS has a number of research applications in knee ligament surgery, and studies continue to explore its use in the treatment of osteochondral lesions. This article reviews the applications of CAS in sports medicine knee surgery and summarizes current literature on clinical outcomes.

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Computer Assistance in Arthroscopic Anterior Cruciate Ligament Reconstruction

Cited by 102 publications

References 19 publications

Development of a femoral template for computer-assisted tunnel placement in anatomical double-bundle ACL reconstruction

Development of a femoral template for computer-assisted tunnel placement in anatomical double-bundle ACL reconstruction

An Extensive Evaluation of Different Knee Stability Assessment Measures: A Systematic Review

Applications of computer navigation in sports medicine knee surgery: an evidence-based review

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