[Using the CAS (computer-assisted surgery) system in arthroscopic cruciate ligament surgery--adaptation and application in clinical practice].
OBJECTIVE
The anterior cruciate ligament (ACL) is of great importance for the knee joint function. In the case of a complete ligament injury there is hardly any chance for complete recovery. The clear advantages of an operative reconstruction by replacing the ACL has been shown in many trails. The accurate placement of the graft's insertions has a significant effect on the mid- and probably long-term outcome of this procedure. Reviewing the literature, there are poor long-term results of ACL replacement in 5 to 52% of all cases, depending on the score system. One of the main reasons for unacceptable results is graft misplacement. This led to the construction of a CAS system for ACL replacement. The system assists this surgical procedure by navigating the exact position of the drilling holes. The Potential deformation quantity of the transplant can be controlled by this system in real time.


RESULTS
40 computer-assisted ACL replacements have been performed under active use of the CAS system. The short-term results are encouraging, no special complications have been seen so far. Prospective long-term follow-up studies are ongoing.


CONCLUSIONS
ACL reconstruction by manual devices has many sources of error. The CAS system is able to give the surgeon reasonable views that are unachieveable by conventional surgery. He is therefore able to control a source of error and to optimise the results. The feasibility of this device in clinical routine use has been proven.
Bernsmann
K
K
Abteilung für Klinische Navigation und Robotik, Orthopädische Klinik, Ruhr-Universität Bochum.
Rosenthal
A
A
Sati
M
M
Ansari
B
B
Wiese
M
M
D016118:Anterior Cruciate Ligament / Q000000981:diagnostic imaging / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000601:surgery*; D007718:Knee Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012984:Software; D013523:Surgical Equipment; D013709:Tendon Transfer / Q000295:instrumentation; D016896:Treatment Outcome; D014584:User-Computer Interface