Validation of a new protocol for computer-assisted evaluation of kinematics of double-bundle ACL reconstruction

Martelli, S.; Zaffagnini, Stefano; Bignozzi, S.; Bontempi, Marco; Marcacci, Maurilio

doi:10.1016/j.clinbiomech.2005.10.009

Cited by 47 publications

(41 citation statements)

References 25 publications

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“…However, the reliability of the test was assessed previously. 25,26,31 Moreover, this methodology was evaluated by other authors with instruments such as KT1000 or Rolimeter and found comparable to a stress test with controlled force. 34,35 The analysis of passive flexion of UKA showed that the implant did not alter the motion pattern of IE tibial rotation or the magnitude of screw-home motion during the range of flexion.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Knee stability before and after total and unicondylar knee replacement: In vivo kinematic evaluation utilizing navigation

Casino

Martelli

Zaffagnini

et al. 2008

Journal Orthopaedic Research

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Surgical navigation systems are currently used to guide the surgeon in the correct alignment of the implant. The aim of this study was to expand the use of navigation systems by proposing a surgical protocol for intraoperative kinematics evaluations during knee arthroplasty. The protocol was evaluated on 20 patients, half undergoing unicondylar knee arthroplasty (UKA) and half undergoing posterior-substituting, rotating-platform total knee arthroplasty (TKA). The protocol includes a simple acquisition procedure and an original elaboration methodology. Kinematic tests were performed before and after surgery and included varus/valgus stress at 0 and 308 and passive range of motion. Both UKA and TKA improved varus/valgus stability in extension and preserved the total magnitude of screw-home motion during flexion. Moreover, compared to preoperative conditions, values assumed by tibial axial rotation during flexion in TKA knees were more similar to the rotating patterns of UKA knees. The analysis of the anteroposterior displacement of the knee compartments confirmed that the two prostheses did not produce medial pivoting, but achieved a postoperative normal behavior. These results demonstrated that proposed intraoperative kinematics evaluations by a navigation system provided new information on the functional outcome of the reconstruction useful to restore knee kinematics during surgery. ß

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Section: Discussionmentioning

confidence: 99%

“…Reliability of the VV tests was reported previously. 25,26,31 Paired samples Student's t-test was used to compare laxity values before and after surgery (VV at 08, VV at 308).…”

Section: Methodsmentioning

confidence: 99%

Knee stability before and after total and unicondylar knee replacement: In vivo kinematic evaluation utilizing navigation

Casino

Martelli

Zaffagnini

et al. 2008

Journal Orthopaedic Research

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show abstract

“…The benefits of simulation-based training to the development of the fundamental technical skills in novice surgical trainees have been recently described by Reznick and MacRae [11], Hamstra and Dubrowski [12] and Hamstra and colleagues [13]. Despite the demonstrated aiding in moving through the initial steep portion of the learning curve, simulation-based training can be expensive, requires considerable faculty time commitment, and may be subject to scheduling conflicts.…”

Section: Resultsmentioning

confidence: 94%

“…This increase in quality gives rise to the expectation of less revision surgeries which represents apart from the benefit for the patient also an economic advantage for each treatment [12][13][14]. …”

Section: Discussionmentioning

confidence: 99%

Computer Assisted Orthopeadic Surgery

2007

Int J CARS

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The objective of the study was to evaluate the precision, concordance, practicability and the early clinical outcome in the use of a computerised navigation system in a comparative study with a group of 100 patients. Two groups of 50 patients each underwent alternately the implantation of a bicondylar knee prosthesis either by means of the freehand navigation system or by means of technical instrumentation. It was found that the computerised navigation-system provided a far higher precision than the technical instrumented implantation. Thus, 94% of the prosthesis implanted with the navigation-system have shown an alignment within a range of plus/minus 3°of the Mikulicz line. Only 46% of the patients operated by means of the technical instrumentation reached this aspired result. Furthermore, the navigation system showed far smaller ranges in the deviation of the aspired alignment. The radiological and virtually alignment values differ at both time points pre and post operative but to a larger extend before surgery. The varus or valgus deviations of the axis appear to be more distinct radiologically under the weight of the patient's body than in the virtual model. The clinical outcome examined by the use of the HSS-Score after a mean follow up of 7 months is very good in both groups, not showing significant differences. On average, the duration of surgery was 13 min longer in the navigated group. We conclude that the benefit of the computerised navigation system is represented in the high improvement of precision. Achieving identical early clinical results like by usage of the technical instrumentation we expect a reduction of aseptic loosening in the navigated group.

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“…Their simulation showed a statistical difference between navigated tunnel positions and those drilled using the standard techniques and equipment, navigation being the more accurate. Martelli et al (1) described a navigation system for ACL reconstruction that incorporated standard clinical tests and ligament laxity assessment for intraoperative evaluation of the reconstruction. They proposed a new protocol that followed the standard acquisition phase for navigated surgery but added intraoperative kinematic tests, including the drawer test at 90 • , the Lachman test at 30 • , internal-external rotation at 90 • and 30 • , and passive range of motion from full extension to full flexion to evaluate the reconstructed ACL intraoperatively.…”

Section: Introductionmentioning

confidence: 99%