title: Navigated vs arthroscopic-guided drilling for reconstruction of acromioclavicular joint injuries: accuracy and feasibility.
abstract: BACKGROUND
  Anatomical reconstruction of the coracoclavicular ligaments is a relatively new technique for acromioclavicular (AC) joint injuries.
  
  
  METHODS
  Eighteen procedures (nine non-navigated, nine navigated) of anatomical reconstruction were performed minimally invasively, using the Tight Rope system, on cadaveric shoulders. Two Kirschner wires were placed, freehand under fluoroscopic control (non-navigated) or 3D C-arm navigated. The insertion point on the clavicle as well as the position of the K-wire in the coracoid were measured in the axial and coronal planes; points were assigned for different zones. For statistical analysis, the significance level was set to p = 0.05.
  
  
  RESULTS
  The accuracy of the entry point in the clavicle was significantly more accurate for the conoidal (p = 0.022) and trapezoidal ( p = 0.0062) drillings. The positioning in the coronal (p = 0.037) and axial (p = 0.0416) planes also showed higher accuracy for the navigated procedures.
  
  
  CONCLUSIONS
  The accuracy of anatomical AC joint reconstruction can be improved using 3D C-arm flat detector navigation.
authors.affiliation: Trauma Department, Hannover Medical School, Germany.
authors.forename: Timo
authors.initials: T
authors.lastname: Stübig
authors.forename: Torsten
authors.initials: T
authors.lastname: Jähnisch
authors.forename: Angela
authors.initials: A
authors.lastname: Reichelt
authors.forename: Christian
authors.initials: C
authors.lastname: Krettek
authors.forename: Musa
authors.initials: M
authors.lastname: Citak
authors.forename: Rupert
authors.initials: R
authors.lastname: Meller
mesh_terms: D000173:Acromioclavicular Joint / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D001182:Arthroscopy / Q000379:methods*; D001864:Bone Wires; D002102:Cadaver; D005240:Feasibility Studies; D005471:Fluoroscopy; D006801:Humans; D021621:Imaging, Three-Dimensional; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods*
keywords: 3D C-arm; Tight Rope; acromioclavicular injuries; computer navigation; flat detector