Patellar ligament with vascular pedicle for anterior cruciate ligament reconstruction:the intraoperative use of computer assisted navigation system combinied with arthroscopy

Zhang Kai; Wang Wei-wei; Wang Xiang-qing

doi:10.3969/j.issn.2095-4344.2016.37.010

Abstract：BACKGROUND:The standard angle between the coronal level of tibial tunnel and the joint surface is 65°-70°. The larger angle is easy to cause impacts, and inversely, the medial joint surface of the tibia plateau wil be worn. <br> OBJECTIVE:To investigate the application and effects of patel ar ligament with vascular pedicle for anterior cruciate ligament reconstruction under computer assisted navigation system combined with arthroscopy. <br> METHODS:Forty patients with anterior cruciate ligament injury were selected, and randomly al otted into two groups (n=20 per group). Patients in traditional surgery group underwent reconstruction by the operator’s experiences, and patients in combination surgery group received the patel ar ligament with vascular pedicle for anterior cruciate ligament reconstruction under computer assisted navigation system combinied with arthroscopy, both based on the same location standard. Subsequently, patients underwent CT continuous CT scans, and the tibial tunnel of anterior cruciate ligament was measured to compare the reconstruction effects. <br> RESULTS AND CONCLUSION:The tibial tunnel and femoral tunnel positions in the combination surgery group were significantly higher than those in the traditional surgery group (P<0.05). The Lysholm scores in the combination surgery group were significantly higher than those in the traditional surgery group at 3, 6 and 12 months after surgery (P<0.05). Compared with the traditional surgery group, the number transmission times was significantly decreased in the combination surgery group (P<0.05). Furthermore, sagittal CT and three-dimensional CT results showed that, in the combination surgery group, the posterior wal of the tibial tunnel closely adhered to the rear cortical bone of the proximal tibia with a distance of<2 mm;a mild rupture appeared at the posterior wal excit of the 1/3 proximal tunnel in traditional surgery group. These results suggest that anterior cruciate ligament reconstuction under computer assisted navigation system combined with arthroscopy achieves satisfactory effects on location of the femoral tunnel. The use of navigation virtual probe avoids the subjective location by surgeons;therefore, it is feasible for clinical treatment.