Computer-assisted navigation in ACL reconstruction improves anatomic tunnel placement with similar clinical outcomes.

Autor: Foo WYX; Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore. Electronic address: yxwayne@gmail.com., Chou ACC; Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Academia, Level 4, Singapore 169865, Singapore., Lie HM; Lee Kong Chian School of Medicine, 11 Mandalay Road, Singapore 308232, Singapore., Lie DTT; Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore; Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Academia, Level 4, Singapore 169865, Singapore.
Jazyk: angličtina
Zdroj: The Knee [Knee] 2022 Oct; Vol. 38, pp. 132-140. Date of Electronic Publication: 2022 Sep 01.
DOI: 10.1016/j.knee.2022.08.006
Abstrakt: Background: While the use of navigation systems in anterior cruciate ligament (ACL) reconstruction theoretically improves tunnel placement accuracy and clinical outcomes, the existing literature remains inconclusive. We aimed to evaluate the potential benefits of navigated ACL reconstruction on tunnel placement and clinical outcomes.
Methods: In this retrospective study, we evaluated a cohort of patients who underwent conventional or navigated (OrthoPilot system) primary ACL reconstruction at our institution from June 2004 to October 2009. Anteroposterior and lateral radiographic knee assessments were evaluated to assess postoperative tunnel positioning. Clinical outcomes, including the International Knee Documentation Committee classification, Lysholm score, and Tegner score, were evaluated preoperatively and 1-year postoperatively. Radiographic and clinical outcomes were compared and analysed using independent 2-sample t-tests and Chi-square tests.
Results: Sixty patients met the inclusion criteria and were included for analysis, comprising of 26 navigated and 34 conventional reconstructions. Postoperative radiographs showed no differences in tibial tunnel position between both groups, but a significantly smaller deviation from the recommended position in the navigated group (navigated: 5.96 %; conventional: 7.92 %; p = 0.008). Femoral tunnel placements in the navigated group were significantly more perpendicularly away from the Blumensaat line (navigated: 38.90 %; conventional: 31.94 %; p = 0.001), with a greater deviation from recommended position (navigated: 11.00 %; conventional: 6.94 %; p = 0.009). There were no differences in 1-year postoperative clinical outcomes (p > 0.05).
Conclusion: Navigated ACL reconstruction resulted in a more anatomic femoral tunnel placement and similar clinical outcomes as conventional reconstruction. Further research should be conducted to clarify the potential biomechanical and clinical impacts of navigated ACL reconstruction.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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