Picard F, DiGioia A M, Moody J, Martinek V, Fu F H, Rytel M, Nikou C, LaBarca R S, Jaramaz B
Center for Orthopaedic Research, Shadyside Hospital, USA.
Comput Aided Surg. 2001;6(5):279-89. doi: 10.1002/igs.10014.
The purpose of this randomized, prospective study was to compare accuracy in tunnel placement as performed with a traditional arthroscopic anterior cruciate ligament (ACL) reconstruction technique and with KneeNavTM ACL, a computer-assisted surgical navigation technique. Two surgeons experienced in ACL reconstruction, but inexperienced in computer-assisted surgical navigation technique, each randomly used traditional arthroscopic guides or KneeNavTM ACL to drill a tunnel in twenty identical foam knees. Placement of the resulting tibial and femoral tunnels was measured with a computer-assisted digitizing method and compared to traditional biplanar radiographs. Statistical analysis with Student's t-test was used to compare the distance from the ideal tunnel placement to the femoral and tibial tunnels. Accuracy of tunnel placement with KneeNavTM ACL was significantly better than that obtained with the traditional arthroscopic technique. Distances from the ideal tunnel placement to the femoral and tibial tunnels were 4.2 +/- 1.8 mm (mean +/- SD) and 4.9 +/- 2.3 mm, respectively, for the traditional arthroscopic technique, and 2.7 +/- 1.9 mm (femur) and 3.4 +/- 2.3 mm (tibia) for KneeNavTM ACL. These differences were statistically different. Tunnel placement for ACL reconstruction with KneeNavTM ACL, an image-based, computer-assisted surgical navigation device with a simple and intuitive interface, was more accurate than with the traditional arthroscopic technique.
本随机前瞻性研究的目的是比较传统关节镜下前交叉韧带（ACL）重建技术与计算机辅助手术导航技术KneeNavTM ACL在隧道置入方面的准确性。两位在ACL重建方面经验丰富但在计算机辅助手术导航技术方面经验不足的外科医生，各自随机使用传统关节镜导向器或KneeNavTM ACL在20个相同的泡沫膝关节上钻出隧道。采用计算机辅助数字化方法测量所得胫骨和股骨隧道的位置，并与传统双平面X线片进行比较。使用学生t检验进行统计分析，以比较理想隧道位置与股骨和胫骨隧道之间的距离。KneeNavTM ACL的隧道置入准确性明显优于传统关节镜技术。传统关节镜技术中，理想隧道位置与股骨和胫骨隧道的距离分别为4.2±1.8毫米（平均值±标准差）和4.9±2.3毫米，而KneeNavTM ACL为2.7±1.9毫米（股骨）和3.4±2.3毫米（胫骨）。这些差异具有统计学意义。使用具有简单直观界面的基于图像的计算机辅助手术导航设备KneeNavTM ACL进行ACL重建时，隧道置入比传统关节镜技术更准确。
