The Use of Intra-Operative Brilliance Amplifier by Novice Surgeons to Improve Bone Tunnels Placement in Anterior Cruciate Ligament Reconstruction during Residency Curriculum: Useful or Not?

Abstract

Objective: Our objective was to evaluate the contribution of the use of intra-operative fluoroscopy on tunnels positioning during the Anterior Cruciate Ligament (ACL) reconstruction. Methods: Between January 2020 and June 2022, a total of 8 ACL reconstructions by the Kenneth Jones (KJ) technique were performed by the same young orthopedic surgeon. Fluoroscopy was used intraoperatively to control the position of the guidewire before bone tunnels reaming. It was available for use in 4 cases who constituting the Fluoroscopy Assisted Reconstruction Group (FARG). Post operatively, we assessed on plane radiographs the interference screws position of the four patients constituting the Fluoroscopy Free Reconstruction Group (FFRG). The measurements of the two groups were compared and analyzed using a Wilcoxon matched-pairs signed-ranks test. Results: Of the 4 patients operated on using intra operative fluoroscopy, imaging allowed us to reposition the tibial and femoral guide wires before reaming in all cases (100%). In the second group (FFRG) of patients (n=4), operated without fluoroscopy, post-operative screw positions were in all patients (100%), more anterior in the tibia and more posterior in the femur than the usual position of bone tunnels of ACL reconstruction. Conclusion: In order to increase the precision of the bone tunnels placement during ACL ligamentoplasty in the hands of novice orthopedic surgeon, intraoperative fluoroscopy constitutes a considerable aid tool.