Department of Trauma and Orthopaedic Surgery, Cologne Merheim Medical Centre, University of Witten/Herdecke, Cologne, Germany.
Arthroscopy. 2011 Sep;27(9):1268-74. doi: 10.1016/j.arthro.2011.03.073. Epub 2011 Jun 24.
The aim of this study was to validate the precision of navigated tunnel positioning using a fluoroscopy-based computer-assisted technique.
Ten human cadaveric knees were operated on under operating room conditions. After resection of the anterior cruciate ligament, referenced fluoroscopic images were acquired to plan the tunnel positions according to established radiologic measurement methods. Afterward, femoral and tibial K-wires were placed by use of navigated drill guides without arthroscopic control. Deviations between the planned and actually drilled tunnel positions at the joint level were analyzed by use of both navigated and radiologic assessment methods.
Navigated analysis between planned and actually drilled tunnel position showed mean deviations of 0.4 mm (range, 0 to 1 mm; SD, 0.52 mm) at the femur and 0.5 mm (range, 0 to 1 mm; SD, 0.5 mm) at the tibia. The radiologic analysis showed mean deviations for the femoral tunnel of 0.83 mm for the depth (range, 0 to 1.46 mm; SD, 0.46 mm) and 0.54 mm for the height (range, 0 to 1.08 mm; SD, 0.41 mm). At the tibia, deviation of 0.74 mm (range, 0 to 1.2 mm; SD, 0.46 mm) was found.
The fluoroscopy-based navigation system used in this study allows for precise tunnel positioning with deviations of 1 mm or less.
This technique provides accurate tunnel placement in anterior cruciate ligament surgery.
本研究旨在验证基于透视的计算机辅助导航隧道定位技术的精确性。
在手术室条件下对 10 个人体尸体膝关节进行手术。在前交叉韧带切除后，根据既定的影像学测量方法获取参考透视图像以规划隧道位置。然后，在没有关节镜控制的情况下，使用导航钻引导器放置股骨和胫骨 K 型钉。使用导航和影像学评估方法分析关节水平上计划和实际钻隧道位置之间的偏差。
导航分析计划和实际钻隧道位置之间的偏差显示，股骨的平均偏差为 0.4 毫米（范围，0 至 1 毫米；SD，0.52 毫米），胫骨的平均偏差为 0.5 毫米（范围，0 至 1 毫米；SD，0.5 毫米）。影像学分析显示，股骨隧道的深度偏差为 0.83 毫米（范围，0 至 1.46 毫米；SD，0.46 毫米），高度偏差为 0.54 毫米（范围，0 至 1.08 毫米；SD，0.41 毫米）。胫骨的偏差为 0.74 毫米（范围，0 至 1.2 毫米；SD，0.46 毫米）。
本研究中使用的基于透视的导航系统允许隧道定位的偏差在 1 毫米或以下，具有较高的精确性。
该技术为前交叉韧带手术提供了准确的隧道放置。
