Computer-Assisted Anatomical Placement of a Double-Bundle ACL through 3D-Fitting of a Statistically Generated Femoral Template into Individual Knee Geometry

Luites, J.W.H.; Wymenga, A. B.; Sati, M.; Bourquin, Yvan; Blankevoort, Leendert; Venne, R. van der; Kooloos, J.G.M.; Stäbli, H.-U.

doi:10.1007/978-3-540-40899-4_114

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…Similar findings have been reported previously. 5,10,[11][12][13][14][15][16] Most of these studies had a smaller number of patients than this series and therefore had to group the patients into more prolonged time intervals. This study is unique in that it has shown a gradual increase in secondary pathology on a monthly basis following the time from injury.…”

Section: Discussionmentioning

confidence: 99%

The incidence of secondary pathology after anterior cruciate ligament rupture in 5086 patients requiring ligament reconstruction

Sri-Ram

Salmon

Pinczewski

et al. 2013

The Bone & Joint Journal

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We reviewed 5086 patients with a mean age of 30 years (9 to 69) undergoing primary reconstruction of the anterior cruciate ligament (ACL) in order to determine the incidence of secondary pathology with respect to the time between injury and reconstruction. There was an increasing incidence of medial meniscal tears and chondral damage, but not lateral meniscal tears, with increasing intervals before surgery. The chances of requiring medial meniscal surgery was increased by a factor of two if ACL reconstruction was delayed more than five months, and increased by a factor of six if surgery was delayed by > 12 months. The effect of delaying surgery on medial meniscal injury was also pronounced in the patients aged < 17 years, where a delay of five to 12 months doubled the odds of medial meniscal surgery (odds ratio (OR) 2.0, p = 0.001) and a delay of > 12 months quadrupled the odds (OR 4.3, p = 0.001). Increasing age was associated with a greater odds of chondral damage (OR 4.6, p = 0.001) and medial meniscal injury (OR 2.9, p = 0.001), but not lateral meniscal injury. The gender split (3251 men, 1835 women) revealed that males had a greater incidence of both lateral (34% (n = 1114) vs 20% (n = 364), p = 0.001) and medial meniscal tears (28% (n = 924) vs 25% (n = 457), p = 0.006), but not chondral damage (35% (n = 1152) vs 36% (n = 665), p = 0.565). We conclude that ideally, and particularly in younger patients, ACL reconstruction should not be delayed more than five months from injury.

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Section: Discussionmentioning

confidence: 99%

The incidence of secondary pathology after anterior cruciate ligament rupture in 5086 patients requiring ligament reconstruction

Sri-Ram

Salmon

Pinczewski

et al. 2013

The Bone & Joint Journal

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“…Different authors have proposed computer-assisted surgery solutions to address the difficulty of tunnel placement. Some systems use only “statistical” rules 5,21 to search for anatomical positioning of the tunnels. More advanced systems combine anatomical data with kinematics measurements to constitute “anatomometric” criteria.…”

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confidence: 99%

Anterior Cruciate Ligament Reconstruction Using Navigation

et al. 2006

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“…Work towards computer-assisted support for multibundle graft placement is described elsewhere. 35 A controversial issue concerning the planning of ligament position based on kinematics is that the ACL-deficient knee is inherently unstable. Dessenne et al compared passive kinematics for cadaver knees both with and without ACL, and found no difference.…”

Section: Discussionmentioning

confidence: 99%

Real-time computerizedin situ guidance system for ACL graft placement

Sati¹,

Stäubli²,

Bourquin³

et al. 2002

Comput. Aided Surg.

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A recent consensus within an international society for sports traumatology revealed that approximately 40% of ACL grafts are being surgically misplaced in current clinical practice. To help solve this problem, a computer-assisted system has been developed at the M.E. Müller Institute for Biomechanics to perform intraoperative planning and guidance of ACL replacement. Dynamic reference bases are fixed on the femur and tibia to track the knee's movement. No intraoperative imaging is required, and potential ligament attachment sites can be directly digitized using a computerized palpation hook in a minimally invasive fashion when used in conjunction with standard endoscopic tools. The palpation hook can be used by the surgeon to interactively define various anatomical structures and reference landmarks that are important for proper ligament positioning. The system can input a standard diagnostic X-ray (sagittal view of the femur) and allows intraoperative registration of this image with the patient to provide valuable X-ray landmarks for intraoperative guidance. The computer helps in situ planning of ligament placement by providing the surgeon with a 3D overview of the relevant anatomical landmarks and information on graft impingement and elongation for various simulated surgical insertions and graft sizes. After planning, the computer helps guide placement of the chosen insertion tunnels. This approach provides an augmented 3D view of knee anatomy and ligament function prior to drilling that is not possible with current procedures. The flexibility of the system in permitting surgeon-defined landmarks and free interpretation of functional factors allows it to support a variety of surgical workflows and techniques.

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Computer-Assisted Anatomical Placement of a Double-Bundle ACL through 3D-Fitting of a Statistically Generated Femoral Template into Individual Knee Geometry

Cited by 4 publications

References 7 publications

The incidence of secondary pathology after anterior cruciate ligament rupture in 5086 patients requiring ligament reconstruction

The incidence of secondary pathology after anterior cruciate ligament rupture in 5086 patients requiring ligament reconstruction

Anterior Cruciate Ligament Reconstruction Using Navigation

Real-time computerizedin situ guidance system for ACL graft placement

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