Department of Trauma, Hand- and Reconstructive Surgery, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
Knee Surg Sports Traumatol Arthrosc. 2012 Nov;20(11):2257-62. doi: 10.1007/s00167-012-1886-9. Epub 2012 Jan 19.
Accurate retrograde drilling for osteochondritis dissecans lesions remains technically challenging. A novel, radiation-free method using an electromagnetic guidance system was developed, and its feasibility and accuracy for retrograde drilling procedures evaluated in an experimental setting.
Sixteen arthroscopically assisted, electromagnetically guided retrograde drilling procedures were performed in 4 human cadaveric knee joints. Therefore, two artificial cartilage lesions were set consecutively on each condyle. Final drill bit position was documented in two planes using fluoroscopy. Subsequently, drilling accuracy was measured in terms of distance from the final position of the drill bit to the articular cartilage surface (D1), and distance between the tip of the drill bit to the centre of the cartilage lesion on the articular cartilage surface (D2). All procedures were timed using a stopwatch.
Successful retrograde drilling was accomplished in all 16 cases. The overall mean time for the retrograde drilling procedures was 361.6 ± 34.7 s. Mean D1 was 2.2 ± 0.5 mm; mean D2 was 0.8 ± 0.7 mm. No complications occurred.
The novel electromagnetic guidance system used in this study showed accurate targeting results, required no radiation, was associated with no complications and demonstrated user-friendliness.
II.
准确地对骺软骨骨软骨炎病变进行逆行钻孔仍然具有技术挑战性。本研究开发了一种新颖的、无辐射的电磁引导系统，在实验环境下评估了其对逆行钻孔的可行性和准确性。
在 4 个人体尸体膝关节中进行了 16 次关节镜辅助的电磁引导逆行钻孔。因此，每个髁骨上连续设置了两个人工软骨病变。使用透视术在两个平面上记录最终钻头位置。随后，根据钻头最终位置到关节软骨表面的距离（D1）和钻头尖端到关节软骨表面上软骨病变中心的距离（D2）来测量钻孔的准确性。所有程序均使用秒表计时。
所有 16 例均成功完成逆行钻孔。逆行钻孔程序的总平均时间为 361.6±34.7s。D1 的平均值为 2.2±0.5mm；D2 的平均值为 0.8±0.7mm。无并发症发生。
本研究中使用的新型电磁引导系统具有准确的靶向结果，无需辐射，无并发症，且易于操作。
II 级。
