Navigation in anterior cruciate ligament reconstruction: State of the art
Date
2023
Type:
Article
item.page.extent
7 p.
item.page.accessRights
Acceso abierto
item.contributor.advisor
ORCID:
Journal Title
Journal ISSN
Volume Title
Publisher
item.page.isbn
item.page.issn
item.page.issne
item.page.doiurl
item.page.other
item.page.references
Abstract
Computer navigation (CN) for anterior cruciate ligament (ACL) surgery has been used mainly for two purposes: to enhance the accuracy of tunnel position and to evaluate the kinematics of the ACL reconstruction (ACLR) and the stability achieved bydifferent surgical techniques.Many studies have shownthatnavigationmay improve the accuracy of anatomical tunnel orientation and position during ACL reconstructive surgery compared with normal arthroscopic tunnel placement, especially regarding the femoral side. At the same time, it has become the gold-standardmethod for intraoperative knee kinematic assessment, as it permits a quantitative multidirectional knee joint laxity evaluation. CN in ACL surgery has been associated with diverse problems. First, in most optic systems additional skin incisions and drill holes in the femoral bone are required for fixation of a reference frame to the femur. Second, additional radiation exposure and extra medical cost to the patient for preoperative planning are usually needed. Third, CN, due to additional steps, has more opportunities for error during preoperative planning, intraoperative registration, and operation. Fourth, soft tissues, including the skin and subcutaneous tissues, are usually not considered during the preoperative planning, which can be a problem for kinematic and stability assessment. Many studies have concluded that ACLR using a CN system is more expensive than conventional surgery, it adds extra time to the surgery and it is not mitigated by better clinical outcomes. This, combined with costs and invasiveness, has limited the use of CN to research-related cases. Future technology should prioritize less invasive intra-operative surgical navigation
Description
item.page.coverage.spatial
item.page.sponsorship
Citation
Figueroa F, Figueroa D, Guiloff R, Putnis S, Fritsch B, Itriago M. Navigation in anterior cruciate ligament reconstruction: State of the art. J ISAKOS. 2023 Feb;8(1):47-53. doi: 10.1016/j.jisako.2022.09.001
Keywords
ACL, Navigation, CAS, Computer-assisted surgery, Anterior cruciate ligament