ISAKOS: 2023 Congress in Boston, MA USA

2023 ISAKOS Biennial Congress ePoster

 

Accuracy and Reproducibility of ntra-operative fluoroscopic measurements for describing the femoral tunnel aperture positions in anatomical ACL reconstruction - analysis using 3D quadrant method on automated 3D reconstructed model

Byung-Hoon Lee, MD, PhD, Incheon KOREA, REPUBLIC OF
Jae-Ang Sim, MD, PhD, Incheon KOREA, REPUBLIC OF
Gachon University College of Medicine,, Incheon, KOREA, REPUBLIC OF

FDA Status Cleared

Summary

Tunnel positioning with fluoroscopic assistance is a feasible and effective method of achieving a consistency of the tunnel placement.

ePosters will be available shortly before Congress

Abstract

Introduction

We aimed 1) to introduce a new automated analysis program of 3D quadrant method to find an ideal femoral or tibial tunnel position; 2) to analyze the accuracy of femoral tunnel positioning during anatomical ACL reconstruction with fluoroscopic assistance compared to conventional 3D-CT analysis, and 3) to demonstrate the clinical advantages of fluoroscopy-assisted tunnel positioning in anatomic ACL reconstruction.

Methods

A total of 15 patients who underwent DB-ACLR from 2010 to 2014 using the TP and OI techniques were evaluated retrospectively. Routine CT scan was evaluated at 5 days postoperatively in all patients. Femoral tunnel location was calculated using

Methods

included as the quadrant method using fluoroscopic radiographs and conventional 3D-CT images, and 3D quadrant method on automated 3D reconstructed model. For each knee, three independent observers conducted the measurements. Reliability of both measurement techniques of quadrant methods using fluoroscopic radiographs and conventional 3D-CT images was evaluated compared to automated 3D reconstructed model.

Results

Taking 0% as the anterior and 100% as the posterior extent, femoral tunnel location measured by 3D quadrant method using automated 3D reconstructed model were 23.1 ± 7.9 % of height and 17.9 ± 4.0 % of depth in AM tunnels, 47.8 ± 6.6% of height and 32.4 ± 6.3% of depth in PL tunnels. We found larger variability and bias in the opinions of what measure a correct femoral tunnel location by 3D quadrant method using conventional 3D-CT images compared than using fluoroscopy. 9.0 % vs.15.6%, of height in AM tunnels, 6.0% vs. 6.9% of depth in AM tunnels, 10.8% vs. 19.1% of height in PL tunnels, respectively. The quadrant method using fluoroscopic radiographs showed more reliable than measurement using conventional 3D-CT image.

Conclusion

Tunnel positioning with fluoroscopic assistance is a feasible and effective method of achieving a consistency of the tunnel placement.

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