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Updated: Aug 29, 2025
Augmented Reality Navigation-Guided Core Decompression for Osteonecrosis of Femoral Head
Published on: April 12, 2022
Computer-assisted navigation in ACL reconstruction improves anatomic tunnel placement with similar clinical outcomes
Wayne Yong Xiang Foo1, Andrew Chia Chen Chou2, Hannah Marian Lie3
1Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore.
Background:
While the use of navigation systems in anterior cruciate ligament (ACL) reconstruction theoretically improves tunnel placement accuracy and clinical outcomes, the existing literature remains inconclusive. We aimed to evaluate the potential benefits of navigated ACL reconstruction on tunnel placement and clinical outcomes.
Methods:
In this retrospective study, we evaluated a cohort of patients who underwent conventional or navigated (OrthoPilot system) primary ACL reconstruction at our institution from June 2004 to October 2009. Anteroposterior and lateral radiographic knee assessments were evaluated to assess postoperative tunnel positioning. Clinical outcomes, including the International Knee Documentation Committee classification, Lysholm score, and Tegner score, were evaluated preoperatively and 1-year postoperatively. Radiographic and clinical outcomes were compared and analysed using independent 2-sample t-tests and Chi-square tests.
Results:
Sixty patients met the inclusion criteria and were included for analysis, comprising of 26 navigated and 34 conventional reconstructions. Postoperative radiographs showed no differences in tibial tunnel position between both groups, but a significantly smaller deviation from the recommended position in the navigated group (navigated: 5.96 %; conventional: 7.92 %; p = 0.008). Femoral tunnel placements in the navigated group were significantly more perpendicularly away from the Blumensaat line (navigated: 38.90 %; conventional: 31.94 %; p = 0.001), with a greater deviation from recommended position (navigated: 11.00 %; conventional: 6.94 %; p = 0.009). There were no differences in 1-year postoperative clinical outcomes (p > 0.05).
Conclusion:
Navigated ACL reconstruction resulted in a more anatomic femoral tunnel placement and similar clinical outcomes as conventional reconstruction. Further research should be conducted to clarify the potential biomechanical and clinical impacts of navigated ACL reconstruction.
