Related Experiment Video
Updated: May 31, 2026
Athymic Rat Model for Evaluation of Engineered Anterior Cruciate Ligament Grafts
Published on: March 26, 2015
Precision of tunnel positioning in navigated anterior cruciate ligament reconstruction
Sven Shafizadeh1, Maurice Balke, Stefan Wegener
1Department of Trauma and Orthopaedic Surgery, Cologne Merheim Medical Centre, University of Witten/Herdecke, Cologne, Germany. sven.shafizadeh@me.com
Purpose:
The aim of this study was to validate the precision of navigated tunnel positioning using a fluoroscopy-based computer-assisted technique.
Methods:
Ten human cadaveric knees were operated on under operating room conditions. After resection of the anterior cruciate ligament, referenced fluoroscopic images were acquired to plan the tunnel positions according to established radiologic measurement methods. Afterward, femoral and tibial K-wires were placed by use of navigated drill guides without arthroscopic control. Deviations between the planned and actually drilled tunnel positions at the joint level were analyzed by use of both navigated and radiologic assessment methods.
Results:
Navigated analysis between planned and actually drilled tunnel position showed mean deviations of 0.4 mm (range, 0 to 1 mm; SD, 0.52 mm) at the femur and 0.5 mm (range, 0 to 1 mm; SD, 0.5 mm) at the tibia. The radiologic analysis showed mean deviations for the femoral tunnel of 0.83 mm for the depth (range, 0 to 1.46 mm; SD, 0.46 mm) and 0.54 mm for the height (range, 0 to 1.08 mm; SD, 0.41 mm). At the tibia, deviation of 0.74 mm (range, 0 to 1.2 mm; SD, 0.46 mm) was found.
Conclusions:
The fluoroscopy-based navigation system used in this study allows for precise tunnel positioning with deviations of 1 mm or less.
Clinical Relevance:
This technique provides accurate tunnel placement in anterior cruciate ligament surgery.