title: Computer-assisted surgery is not more accurate or precise than conventional arthroscopic ACL reconstruction: a prospective randomized clinical trial.
abstract: BACKGROUND
  Accurate and precise tunnel placement is critical to the success of anterior cruciate ligament (ACL) reconstruction. A new development, computer-assisted surgery, aids in placement of the ACL bone tunnels during surgery. Our hypothesis was that computer-assisted ACL reconstruction would allow more accurate and precise tunnel placement compared with conventional surgery.
  
  
  METHODS
  In a prospective, double-blind, randomized clinical study, 100 patients eligible for ACL reconstruction with a transtibial technique were stratified by surgeon and randomized to either conventional or computer-assisted surgery. Measurement of femoral and tibial tunnel placement with use of three-dimensional computed tomography (CT) was used as the primary outcome to compare conventional ACL surgery with computer-assisted surgery.
  
  
  RESULTS
  The placement of the femoral tunnel did not differ between groups (mean, 39.7% of the proximal-distal distance on the intracondylar axis [Blumensaat line] in the conventional group compared with 39.0% in the computer-assisted surgery group; p = 0.70). The anterior-posterior positioning of the tibial tunnel on the tibial plateau also did not differ significantly (38.9% in the conventional group compared with 38.2% in the computer-assisted surgery group; p = 0.58). There was no significant difference in the precision of either the femoral or the tibial tunnel placement between the two groups.
  
  
  CONCLUSIONS
  There was no significant difference in either the accuracy or the precision of tunnel placement between conventional and computer-assisted ACL reconstruction.
authors: Department of Orthopaedic Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands. d.meuffels@erasmusmc.nl
authors: Duncan E
authors: DE
authors: Meuffels
authors: Max
authors: M
authors: Reijman
authors: Jan A N
authors: JA
authors: Verhaar
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D001182:Arthroscopy / Q000379:methods*; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D015601:Injury Severity Score; D007718:Knee Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology; D018579:Patient Selection; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult