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Application of a computerised navigation technique to assist arthroscopic anterior cruciate ligament reconstruction

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Abstract

Purpose

Based on biomechanical cadaver studies, anatomical double-bundle reconstruction of the anterior cruciate ligament (ACL) was introduced to achieve better stability in the knee, particularly in respect of rotatory loads. Previously, the success of ACL reconstruction was believed to be mainly dependent on correct positioning of the graft, irrespective of the number of bundles for which computer-assisted surgery was developed to avoid malpositioning of the tunnel. The aim of this study was to compare rotational and translational stability after computer-navigated standard single-bundle and anatomical double-bundle ACL reconstruction.

Methods

The authors investigated 42 consecutive patients who had undergone the single-bundle or double-bundle ACL reconstruction procedure using autogenous hamstring tendon grafts and ENDOBUTTON fixation in patients who had been followed up for a minimum of 24 months. Post-operative anteroposterior and rotational laxity was measured with the KT3000 and compared between groups.

Results

Both surgical procedures significantly improve rotational and translational stability compared to the preoperative ACL-deficient knee (P<0.05). No significant differences were registered between groups with regard to anteroposterior displacement of the tibia. The International Knee Documentation Committee (IKDC) and Lysholm scores were significantly higher in the double-bundle group. However, the results were excellent in both groups.

Conclusions

The use of computer-assisted ACL reconstruction, which is a highly accurate method of graft placement, could be useful for inexperienced surgeons to avoid malposition. Long-term results of at least five years are needed to determine whether double-bundle ACL reconstruction, which was associated with improved rotational laxity and significantly better IKDC and Lysholm scores compared to the standard single-bundle ACL reconstruction procedure, exerts an influence in terms of avoiding osteoarthritis or meniscus degeneration.

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Acknowledgment

This study received financial support from the Emerging Scientist Project of Shenzhen Second People’s Hospital and the Guangdong Province Medical Research Fund (the project number is B2012320) and Guangdong Province outstanding youth innovative talent training program (Seedling project, the project number is 2012LYM_0120).

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Authors and Affiliations

  1. Department of Sports Medicine, Shenzhen Second People’s Hospital, No.3002, Sungang W. Road, Futian District, Shenzhen, 518035, People’s Republic of China

    Weimin Zhu, Wei Lu, Yun Han, Shi Hui, Yangkan Ou, Liangquan Peng, Wenzhe Fen & Daping Wang

  2. Beijing University of Technology, 100 Pinglyuan, Chaoyang District, Beijing, 100124, People’s Republic of China

    Linlin Zhang & Yanjun Zeng

Authors
  1. Weimin Zhu
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  2. Wei Lu
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  3. Yun Han
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  4. Shi Hui
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  5. Yangkan Ou
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  6. Liangquan Peng
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  7. Wenzhe Fen
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  8. Daping Wang
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  9. Linlin Zhang
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  10. Yanjun Zeng
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Corresponding authors

Correspondence to Daping Wang or Yanjun Zeng.

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Zhu, W., Lu, W., Han, Y. et al. Application of a computerised navigation technique to assist arthroscopic anterior cruciate ligament reconstruction. International Orthopaedics (SICOT) 37, 233–238 (2013). https://doi.org/10.1007/s00264-012-1764-6

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  • DOI: https://doi.org/10.1007/s00264-012-1764-6

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