Document Detail


Comparative study of knee anterior cruciate ligament reconstruction with or without fluoroscopic assistance: a prospective study of 73 cases.
MedLine Citation:
PMID:  17874244     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Correct placement of both tibial and femoral tunnels is one of the main factors for a favorable clinical outcome after anterior cruciate ligament (ACL) reconstruction. We used an original system of computer assisted surgery (CAS). The system, based on fluoroscopic guidance combined with special graphical software of image analyzing, showed to the surgeon, before drilling, the recommended placement of tibial and femoral tunnel centers. We compared the first anatomical and clinical results of this procedure to the usual one single incision technique. MATERIALS AND METHODS: We conducted a prospective study on 73 patients; 37 patients were operated on with CAS and 36 without CAS, by the same senior surgeon. The mean age was 27 years for both groups. Every patient was reviewed at an average of 2.2 years (range 1-4.5) by an independent observer, using IKDC scoring system, KT-1000, and passive stress radiographs. RESULTS: Time between ACL rupture and reconstruction averaged 30 months for both groups. CAS needed 9.3 min extra surgery time. Clinical evaluation was graded from A to C as per the IKDC scoring system: 67.6% A, 29.7% B, 2.7% C with CAS; and 60% A, 37.1% B, 2.9% C without CAS. IKDC subjective knee evaluation score averaged 89.7 with CAS and 89.5 without CAS. Pre operative KT-1000 maxi manual differential laxity averaged 7. At revision time, all the patients after CAS had a differential laxity less than 2 and 97.7% without CAS. Stress X-rays differential laxity averaged 2.4 mm with CAS and 3 mm without CAS. The area of dispersion of the tunnels' center was smaller on the femoral side using the CAS method. There was no statistically significant difference between both groups using IKDC score, KT-1000 and passive stress radiographs. CONCLUSIONS: The CAS method provided a more accurate and reproducible tunnels placement without clinical significant effect.
Authors:
Julien Chouteau; I Benareau; R Testa; M H Fessy; J L Lerat; B Moyen
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2007-09-15
Journal Detail:
Title:  Archives of orthopaedic and trauma surgery     Volume:  128     ISSN:  0936-8051     ISO Abbreviation:  Arch Orthop Trauma Surg     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-06     Completed Date:  2009-01-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9011043     Medline TA:  Arch Orthop Trauma Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  945-50     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery and Sport Medicine, Centre Hospitalier Lyon-Sud, Chemin du Grand Revoyer, Pierre Bénite Cedex, France. juchout@club-internet.fr
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anterior Cruciate Ligament / surgery*
Bone-Patellar Tendon-Bone Graft
Female
Fluoroscopy*
Humans
Male
Middle Aged
Outcome Assessment (Health Care)*
Prospective Studies
Surgery, Computer-Assisted
Tendons / transplantation
Time Factors
Young Adult

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