Accuracy of Anterior Cruciate Ligament Footprint Localization: Intraoperative versus Preoperative Magnetic Resonance
Abhijit More1, Bhagyashri Soor2, Yeswanth Athukuri1
1Department of Orthopaedics, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, Maharashtra, India.
Background:
Accurate localization of the anterior cruciate ligament (ACL) footprint is essential for successful reconstruction. Conventional intraoperative techniques may lack precision.
Aims And Objectives:
To compare the accuracy of intraoperative methods with preoperative MRI-based techniques for ACL footprint localization.
Materials And Methods:
A comprehensive literature review (2023-2025) was conducted using PubMed and Google Scholar. Studies comparing MRI-based and intraoperative techniques were analyzed for accuracy and clinical outcomes.
Results:
3D MRI demonstrated high accuracy with deviations of ~1-2 mm. Both 2D and 3D MRI showed excellent reliability (<1.2 mm difference). In contrast, intraoperative methods showed greater variability (~4-5 mm). Navigation and patient-specific guides improved accuracy but still demonstrated minor deviations (~5 mm).
Conclusion:
MRI-based planning, especially 3D MRI combined with navigation or patient-specific guides, provides superior accuracy in ACL footprint localization and may reduce graft failure rates.
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