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Navigated vs arthroscopic-guided drilling for reconstruction of acromioclavicular joint injuries: accuracy and
Timo Stübig1, Torsten Jähnisch, Angela Reichelt
1Trauma Department, Hannover Medical School, Germany.
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.
Conclusion:
The accuracy of anatomical AC joint reconstruction can be improved using 3D C-arm flat detector navigation.