Accuracy of bone tunnel in anterior cruciate ligament reconstruction using electromagnetic navigation system
10.3969/j.issn.2095-4344.2601
- Author:
Guoqing JIA
1
Author Information
1. Department of Sports Medicine, Weihai Central Hospital Affiliated to Qingdao University
- Publication Type:Journal Article
- Keywords:
Anterior cruciate ligament;
Femoral tunnel;
Magnetic channel navigation system;
Reconstruction;
Tibial tunnel
- From:
Chinese Journal of Tissue Engineering Research
2020;24(15):2374-2380
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: Accuracy and repeatability of bone tunnel in anterior cruciate ligament reconstruction has been a difficult point in surgery. As a new navigation technology, electromagnetic navigation system can realize three-dimensional positioning in application, hoping to make up for the mistakes made by surgeons. OBJECTIVE: To evaluate the feasibility and accuracy of a new electromagnetic navigation system in anterior cruciate ligament reconstruction. METHODS: Totally 30 cases of fresh frozen knee joint were treated with anterior cruciate ligament amputation to prepare knee joint specimens with anterior cruciate ligament rupture. They were randomly divided into two groups, using magnetic channel navigation combined with arthroscopy (navigation group) and traditional arthroscopy (control group). Postoperative lateral radiography of knee joint was performed to observe the exit position of bone tunnel in two groups, to measure the position of the middle of the tibial tunnel on the tibial plateau, to measure the a angle between the Blumensaat line and the axis of the tibial tunnel, and to measure the position of the femoral tunnel on the Blumensaat line. RESULTS AND CONCLUSION: (1) In the navigation group, the lateral X-ray radiographs of knee joint extension showed that the front edge of all tibial tunnels was slightly behind of Blumensaat line, avoiding intercondylar collision. In control group, two cases were located slightly ahead of Blumensaat line. (2) The distance (a) between the Blumensaat line at the level of tibial plateau and the front edge of the tibial tunnel, the ratio of a to width of tibial plateau anteroposterior diameter (c) and alpha angles of tibial tunnel were smaller in the navigation group than in the control group (P < 0.05). This increased the accuracy of tibial tunnel positioning. (3) There was no significant difference in the location of the tibial tunnel between the two groups (P=0.323). However, the range of the central position of the tunnel (38.1 %-53.8%) was slightly lower in the navigation group than that in the control group (30.4%-56.4%). The range of a distance (0.1-3.2 mm) in the navigation group was smaller than that in the control group (-2.1-5.7 mm), and the location of bone marrow tract was more stringent, which increased the repeatability of location tibial tunnel. (4) The position of femoral tunnel was in the position of the posterior upper quadrant (4/4) in all navigation groups and in 13 cases of the control group. The position of femoral tunnel in the navigation group was more backward compared with the control group (P=0.001). The femoral tunnel in the navigation group could ensure the stability of the knee. (5) In the cadaveric knee joint experiment, magnetic navigation technology can be used to assist the location of bone tunnel in anterior cruciate ligament reconstruction, increase the accuracy and repeatability of bone tunnel, but there are still artificial and magnetic channel navigation system errors, which still need to be improved in clinical application.
