Abstract
Rupture of the Anterior Cruciate Ligament (ACL) is a common problem, mainly in young and active adults. It may lead to premature degenerative arthritis of the knee joint. The current standard surgical procedure is the endoscopic reconstruction of the ACL using a central-third bone — patellar tendon — bone graft. Correct placement, especially the isome-try of the femoral and tibial insertion of the graft, is of primary importance for the stability of the reconstructed ligament. However, planning the correct insertion points and accurately executing the planned procedure is often difficult. In this paper we report on a fluoroscopic navigation system using intra-operative x-ray images to identify the correct position of the insertion points, and to guide the drilling of the tibial and femoral tunnel.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
To, J. T., Howell, S. M., and Hull, M. L., “Contributions of femoral fixation methods to the stiffness of ACL replacements at implantation.”, Arthroscopy., 15(4): 379–387, 1999.
Butler, J. C., Branch, T. P., and Hutton, W. C., “Optimal graft fixation-the effect of gap size and screw size on bone plug fixation in ACL reconstruction.”, Arthroscopy, 10(5): 524–529,1994.
Boden, B., Migaud, H., Gougeon, F., Debroucker, M. J., and Duquennoy, A., “Effect of graft position on laxity after ACL reconstruction. Stress radiography in 90 knees 2 to 5 years after autograft.”, Acta Orthop.Belg., 62(1): 2–7, 1996.
Bylski-Austrow, D. I., Grood, E. S., Hefzy, M. S., Holden, J. P., and Butler, D. L., “ACL replacements: a mechanical study of femoral attachment location, flexion angle at tensioning, and initial tension.”, J.OrthopRes, 8: 522–531, 1990.
Djian, P., Christel, P., Roger, B., and Witvoet, J., “Roentgenographic and magnetic resonance imaging of anterior cruciate reconstruction using a patellar tendon graft-correlations with physical findings.”, Knee.Surg.Sports Traumatol.Arthrose., 2(4): 207–213, 1994.
Klos, T.-V. S., Harman, M. K., Devilee, R. J., Banks, S. A., and Cook, F. F., “Patellar tendon graft position after ACL reconstruction. Interobserver variability on lateral radiographs.”, Acta Orthop.Scand., 70(2): 180–184, 1999.
Klos, T.-V. S., Banks, A. Z., Lambregts, K-A. H., Banks, S. A., Cook, F. F., “Radiographic parameters for ACL reconstruction.”, Proceedings of CAR’96: Computer Assisted Radiology-10 th International Symposium, Ed.: Vannier, M. W., Inamura, K., and Farman, A. G., 832–836. Springer, Paris,France, 1996.
Collette, M., Mertens, H., Peters, M., and Chaput, A., “Radiological method for preoperative determination of isometric attachment points of an ACL graft.”, Knee.Surg.Sports Traumatol.Arthrose., 4(2): 75–83, 1996.
Feller, J. A., Glisson, R. R., Seaber, A. V., Feagin, J. A. J., and Garrett, W. E. J., “Graft isometricity in unitunnel ACL reconstruction: analysis of influential factors using a radiographic model.”, Knee.Surg.Sports Traumatol.Arthrose., 1(3-4): 136–142, 1993.
Lintner, D. M., Dewitt, S. E., and Moseley, J. B., “Radiographic evaluation of native ACL attachments and graft placement for reconstruction. A cadaveric study.”, Am.J.Sports Med, 24(1): 72–78,1996.
Khalfayan, E. E., Sharkey, P. F., Alexander, A. H., Bruckner, J. D., and Bynum, E. B., “The relationship between tunnel placement and clinical results after ACL reconstruction.”, Am.J.Sports Med., 24(3): 335–341, 1996.
Muneta, T., Yamamoto, H., Ishibashi, T., Asahina, S., Murakami, S., and Furuya, K., “The effects of tibial tunnel placement and roofplasty on reconstructed ACL knees.”, Arthroscopy., 11(1): 57–62, 1995.
Howell, S. M., “Principles for placing the tibial tunnel and avoiding roof impingement during reconstruction of a torn ACL.”, Knee.Surg.Sports Traumat.Arthrose.,6(Suppl):S49–S55, 1998.
Ikeda, H., Muneta, T., Niga, S., Hoshino, A., Asahina, S., and Yamamoto, H., “The long-term effects of tibial drill hole position on the outcome of ACL reconstruction.”, Arthroscopy., 15(3): 287–291, 1999.
Bernard, M., Hertel, P., Hornung, H., and Cierpinski, T., “Femoral insertion of the ACL. Radiographic quadrant method.”, Am.J.Knee.Surg., 10(1): 14–21, 1997.
Cassisa, G., Nasi, M., Peretti, M., and Pappalardo, S., “X-ray evaluation of interferential femoral screw positioning in ACL reconstruction.”, Chir.Organi.Mov., 81(3): 257–261, 1996.
Berg, E. E., “Parsons’ knob (tuberculum intercondylare tertium). A guide to tibial ACL insertion.”, Clin.Orthop.292: 229–231, 1993.
Morgan, C. D., Kaiman, V. R., and Grawl, D. M., “Definitive landmarks for reproducible tibial tunnel placement in ACL reconstruction.”, Arthroscopy, 11(3): 275–288, 1995.
Milankov, M. and Miljkovic, N., “A new positioning device for precise femoral insertion of the ACL autograft”, Knee.Surg.Sports Traumatol.Arthrosc., 8(3): 149–153, 2000.
Klos, T.-V. S., Habets, R. J., Banks, A. Z., Banks, S. A., Devilee, R. J., and Cook, F. F., “Computer assistance in ACL reconstruction.”, Clin.Orthop.354: 65–69, 1998.
Klos, T.-V. S., Banks, S. A., Cook, F. F., Harman, M. K., Banks, A. Z., Ed, b. S., Morgan, K., Sieburg, H. B., Mattheus, R., and Christensen, J. P. “Interactive fluoroscopic controlled ACL.” InteractiveTechnology and the New Paradigm for Healthcare.Medicine meets Virtual Reality III Proceedings): 173-174. San Diego, CA, USA, 1995
Koppe, R., Klotz, E., Op de Beek, J., and Aerts, H. “3D vessel reconstruction based on rotational angiography.”, Proceedings CAR’95, H.U. Lemke, K. Inamura, C.C. Jaffe, M.W. Vannier (editors)): 101–107, Berlin, 1995.
Grass, M., Koppe, R., Klotz, E., Proksa, R., Kuhn, M. H., Aerts, H., Op, d. B., and Kemkers, R., “Three-dimensional reconstruction of high contrast objects using C-arm image intensifier projection data”, Comput.Med.Imaging Graph., 23(6): 311–321, 1999.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2002 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Sabczynski, J. et al. (2002). Computer assisted arthroscopic anterior cruciate ligament reconstruction. In: Lemke, H.U., Inamura, K., Doi, K., Vannier, M.W., Farman, A.G., Reiber, J.H.C. (eds) CARS 2002 Computer Assisted Radiology and Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-56168-9_43
Download citation
DOI: https://doi.org/10.1007/978-3-642-56168-9_43
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-62844-3
Online ISBN: 978-3-642-56168-9
eBook Packages: Springer Book Archive