Computer assistance in arthroscopic anterior cruciate ligament reconstruction

Accurate placement of the graft is considered one of the most important factors in anterior cruciate ligament surgery. However, reconstruction with contemporary guiding systems still can result in unacceptable graft placement variability. To improve the reproducibility of graft placement, intraoperative visual feedback was added to the arthroscopic technique. First, fluoroscopic visualization was added to evaluate guidewire placement before tunnel drilling. Second, computer graphic overlays were added to the fluoroscopic view. Three groups of patients were treated: 29 patients with arthroscopy, 53 patients with fluoroscopy added, and 50 patients with computer overlays added. Graft placement variability was reduced significantly with fluoroscopic visualization. Computer overlays resulted in additional significant reductions in graft placement variability. Simple visual enhancements seem to be useful in improving the accuracy of arthroscopic anterior cruciate ligament reconstruction.