Abstract
With the increasing number of primary anterior cruciate ligament (ACL) reconstructions,
revisions are more frequent. The most common cause of technical failure in primary
ACL reconstruction is the bone tunnel misplacement. An incorrectly positioned bone
tunnel or tunnel enlargement interferes with correct tunnel placement, which is critical
for successful restoration of the knee kinematics. We describe a technique using fluoroscopic-based
navigation systems to place the tibial tunnel in an ideal position with accuracy and
reproducibility in the revision ACL reconstruction. With a reference frame attached
to the middle part of the tibia, the conventional tibial guide with a tracking device
provides surgeons with real-time visual guidance in multiple image planes. In 3 revision
cases with incorrect tibial tunnels and without bone enlargement, the new tibial tunnel
could be created in the ideal position under the control of the navigation system.
Computer navigation and virtual ligament reconstruction enable surgeons to control
bone tunnel positioning during technically demanding revision ACL cases.
Key Words
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References
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Article info
Publication history
Published online: January 08, 2007
Footnotes
The authors report no conflict of interest.
Cite this article as: Nakagawa T, Hiraoka H, Fukuda A, et al. Fluoroscopic-based navigation–assisted placement of the tibial tunnel in revision anterior cruciate ligament reconstruction. Arthroscopy 2007;23:443.e1-443.e4 [doi:10.1016/j.arthro.2006.07.036].
Identification
Copyright
© 2007 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
