The Study And Clinical Application Of Virtual Surgery Assisted Anterior Cruciate Ligament Reconstruction

Objective:Anterior cruciate ligament reconstruction is commonly used surgical approach for anterior cruciate ligament injury in the current treatment, usually surgery, bone tunnel positioning rely on the personal experience of the surgeon, the information obtained by the surgical microscope field of vision is limited, and therefore will affect the postoperativeknee function recovery, in severe cases can lead to surgical failure. For this clinical difficulty, using self-developed BioMxsf software, to establish the method of three-dimensional image model of the knee, while the establishment of a virtual surgery system-assisted anterior cruciate ligament reconstruction surgery pro-cess, and in clinical practice in clinical In order to establish a safe, accurate, individu-alized surgical plan, and lay the foundation for further virtual surgery system and pro-mote the concept of application to other medical areas.Material and methods:1. To establish the method of three-dimensional image model of the knee, the use of spiral CT scanning, the volunteers knee respectively the thickness of the cross-sec-tion and longitudinal section of0.75mm,0.5mm pitch, continuous image data. The scan results are exported to deposit on a graphics workstation in DICOM format and use of independent research and development BioMxsf software based on image data combined with the Software automatically functions, were established based on the CT image data, including the femur, tibia, fibula and three-dimensional model of the knee. And the establishment of a virtual surgery system to support the operational processes of the anterior cruciate ligament reconstruction surgery. Spiral CT scan of the knee of the volunteers, combined with the requirements of the anterior cruciate ligament reconstruction surgery, to import data into the virtual surgery system for re-construction of the bone tunnel positioning, measuring the length of the bone tunnel, the inner diameter measurement.2.29cases of anterior cruciate ligament injury patients were divided into two groups, a group of virtual surgery system auxiliary, a group of conventional surgery group. All patients should be carried out routine preoperative assessment, MRI and CT. Surgical module group of patients to import data into the line three-dimensional reconstruction of this system, measurement data. Conventional surgery group only routine perioperative preparation. And then using the same standard arthroscopic anterior cruciate ligament reconstruction surgery. The patients were followed up for4-12months, an average of9.3months, to assess the knee. Results:1. The use of spiral CT (MSCT3D) VR technology, MPR technology, you can complete the establishment of containing the femur, tibia, fibula three-dimensional model of the knee, and meet the next anterior cruciate ligament reconstruction surgery, preoperative planning requiresthe MPR axial, sagittal, coronal reconstruction, to meet the positioning of the bone tunnel, bone tunnel length and angle measurement of individual measurement needs.2. The application of spiral CT technology to guide clinical cruciate ligament reconstruction surgery, postoperative knee function recovery is superior to conven-tional surgery patients related to iatrogenic injury did not occur with the equipment placed. Surgery module group, the average operative time was89.7min, the conventi-onal surgical operation time was107.4min surgery was significantly shorter; postop-erative Lysholm score, IKDC score, and conventional surgery group compared no significant American Knee Society score (The Knee Society,) articular score compar-ed with the conventional surgery group,80.24±2.15, surgery module group80.75±3.06, not statistically significant. Functional score compared with conventional surge-ry group (81.44±3.14), surgery module group (84.97±3.97), postoperative knee function better than conventional surgery group, the difference was statistically sign-ificant (P<0.05).Conclusions:1. Knee spiral CT medical image data, you can set up the faithful to the human knee anatomical structure of the three-dimensional model of the knee, and further establish the standard virtual surgery system assisted anterior cruciate ligament reconstruction surgery process. Virtual bone tunnel positioning technology to help doctors more three-dimensional image of the knee joint, and bone tunnel length and angle data, more precise surgical positioning, reducing surgical risks, choose the best surgical approach, and verify the support of virtual system feasibility of the anterior cruciate ligament reconstruction surgery.2. Virtual surgery system can be fully demonstrated the preoperative anatomical structural details of the knee, measurement of individual data, the design of a reasonable surgical approach to improve the preoperative preparation, intraoperative strictly follow the measurement parameters designed bone tunnel, you can shorten the operative time, reduce bleeding, improving accuracy and security of the anterior cruciate ligament surgery, to reduce the risk of surgical failure, surgery is no longer just rely on the personal touch and experience, accurate bone tunnel positioning will be more likely.