Abstract
Aims: Functional results of anterior cruciate ligament (ACL) is closely related to the anatomical position of the graft. Femoral or tibial miss placements are associated with increase laxity, decrease range of motion. Based on anatomical dissections we developed a triangle method able to be used as fluoroscopic intra-operative landmark to increase the reproductibility of the placements. Methods: A lateral X ray of normal knee is mandatory before the surgical procedure. During the ACL reconstruction using patellar tendon a pin is placed to determine the tibial tunnel, and a small screw is inserted at the femoral ACL location. Under imagine intensifier, a lateral X ray of the operated knee is realised. The picture is exported and analysed on a PC computer. The surgical placement is compared with the ACL center position according to the triangle method. 35 knees have been operated and compared with 35-paired knees operated with the same technique and operator. Results: The mean distance between the ACL center and the surgically chosen femoral position is 7.5 ± 1.9 mm for the standard surgery and 4.9 ± 1.3 mm for the fluoroscopy based surgical navigation. The Wilcoxon test for small-paired series indicates a statistical significance (p=0.001). The mean extra operative time is 15 ± 7mn. Conclusion: This technique is simple, easy and rather fast. It gives to the surgery a significative improvement for positioning the ACL graft on the femoral side. It has to be confirmed for larger and by long term clinical results.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
