A research for accuracy of infrared computer navigation in arthroscopic anterior cruciate ligament reconstruction bone tunnel positioning of assisted

Abstract

Objective To explore the accuracy and feasibility of infrared computer navigation for femur, tibia tunnel posi-tioning in arthroscopic anterior cruciate ligament (ACL) reconstruction. Methods Data of patients who had undergone ACL reconstruction using infrared computer navigation from January 2012 to June 2013 were retrospectively analyzed. There were 26 males and 9 females, with an average age of 26.8 years old. 35 patients were with concomitant meniscal injury 21 cases, and 3 cases with medial collateral ligament injury. All patients were treated with gracilis and semitendinosus knit stitch as grafts, and bone ends were made with hydroxyapatite extrusion screws, door-shaped nails and porous plate. Results The mean follow-up time was 16 months. The rate of postoperative femoral tunnel site measurements was 63.8%±6.6%, and tibial tunnel site measurements was 45.7%±4.2%. 1 patient appeared heterotopic ossification in tibia tracker pinhole 3 months after surgery, and the joint activities was normal. Lachman test: there were 1 case with II degree, 30 with III degree, and 4 with IV degree before operation, and 33 with I degree, 1 with II degree, 1 with III degree after operation. The KT-1000 test was from 6.47±0.75 mm preoperatively to 1.01±1.14 mm postoperatively. Preoperative knee laxity differences was more than 5 mm in 32 cases, 3-5 mm in 3, and after operation they were 0-3 mm in 31, 3-5 mm in 2, and less that 0 mm in 2 cases. Lysholm score and Tegner scores were from preoperative 52.74± 10.91 points and 4.64±1.34 points to postoperative 93.97±4.13 and 6.56±0.81 points. ROM was from 85.6°±11.2° to 118.3°±5.7°; 33 cases were without flexion and extension limited; two cases had knee flexion, extension limitation less than 10°. After straight leg raising training and proprioception functional training for 6 months, the knee ROM returned to normal. Conclusion Infrared computer assisted navigation system for arthroscopic ACL reconstruction is to navigate through the use of anatomical landmarks and kinematic data, kinematic data by detecting and recording the knee, selected a secure tunnel site, viable surgical method, you can make femur, tibia tunnel position more accurately, good curative effect evaluation. Key words: Anterior cruciate ligament reconstruction; Knee joint; Arthroscopy; Surgery, computer-assisted