Comparison of navigated ACL graft isometry and obliquity in native ACL vs. ACL reconstructions

摘要

Introduction: Anterior cruciate ligament (ACL) reconstruction is the treatment of choice for young, active individuals with an ACL deficient knee and symptoms of instability. While this procedure is widely performed, estimated rates of revision surgery are as high as 10-20%. Among failures due to surgical techniques, the most common technical error is poor tunnel placement. Surgical navigation offers an additional means of supervising tunnel positioning by augmenting standard anatomic landmarks with providing quantitative isometric behavior of graft fibers during load or rotational maneuvers as well as 3-D graft obliquity data Methods: Five fresh frozen cadaveric knees were utilized. The Praxim Surget-ics surgical navigation system was used to acquire kinematic data prior to ACL transection and was used to create virtual tunnels after the anteromedial (AM), central, and posterolateral (PL) aspects of the footprints were digitized. Three 9 mm virtual grafts were constructed: 1) AM bundle 2) PL bundle and 3) Central region. Graft obliquity of the central fiber and the isometry profile were determined as previously described.