Validation of a new protocol for computer-assisted evaluation of kinematics of double-bundle ACL reconstruction.
BACKGROUND
Computer-assisted surgery is useful to increase the precision of anterior cruciate ligament (ACL) surgical procedure, but could be even more important in evaluating the global performance of reconstructed ACL. This paper describes a new protocol for an accurate and extensive computer-assisted evaluation of single- and double-bundle reconstructions of ACL.


METHODS
The protocol consists of the acquisition of the leg axes, ACL and graft insertions by a navigation system, and tracking of the knee motion during the classical kinematic test of knee stability. These data are elaborated by computer software in order to compute graft biomechanical behaviour and the knee kinematics and estimate the performance of the intervention.


RESULTS
The proposed protocol was validated on three cadaver knees. It resulted minimally invasive, effective to describe graft kinematic performance and able to provide a 3D reliable description of the reconstructed knee.


CONCLUSIONS
The protocol is an extension of the present evaluation of computer-assisted packages and includes additional kinematic tests and computations. The scientist-reader can find important details on tested computations to implement a similar computer-assisted procedure for new applications in knee surgery, while the surgeon can find in this procedure a means to improve the evaluation of ACL reconstruction and identify the residual laxity.
Martelli
S
S
Laboratorio di Biomeccanica, Istituti Ortopedici Rizzoli, 40136 Bologna, Italy. s.martelli@biomec.ior.it
Zaffagnini
S
S
Bignozzi
S
S
Bontempi
M
M
Marcacci
M
M
D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001696:Biomechanical Phenomena / Q000379:methods*; D002102:Cadaver; D003198:Computer Simulation; D006801:Humans; D066298:In Vitro Techniques; D007593:Joint Instability / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D007719:Knee Joint / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D008954:Models, Biological; D011379:Prognosis; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods*; D012984:Software; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome