Clinical Study Of Computer Navigation-assisted Anterior Cruciate Ligament Reconstruction

Objective The curative effect of anterior cruciate ligament reconstruction is closely related to the bone tunnel position of the graft.in order to improve the accuracy of tunnel location during reconstruction,computer navigation system was used to assist anterior cruciate ligament reconstruction.to explore the accuracy and clinical effect of computer navigation-assisted anterior cruciate ligament reconstruction.Methods A retrospective case-control study was conducted in 50 patients with anterior cruciate ligament rupture treated in the Department of Orthopaedics,Daping Hospital,Army Medical University from March 2017 to December 2018,including 37 males and 13 females.There were 25 cases in each group of navigation group and control group.The navigation group was assisted by computer navigation system to locate the inner mouth of intra-articular femoral and tibial tunnel,and the control group was used to locate the inner mouth of intra-articular femoral and tibial tunnel manually.The operation time and postoperative complications of the two groups were recorded.After operation,CT three-dimensional reconstruction or MRI examination of knee joint was performed,and the data were imported into Mimics19.0 to form three-dimensional images of knee joint.The position of the inner entrance of the tunnel of femur and tibia was evaluated.The proportion of the position of the tunnel of femur on the lateral intercondylar surface of femur was evaluated by grid method,and the proportion of the position of tibia tunnel on the platform of tibia was evaluated.The position of the tunnel of the femur side was represented by the proportion site from the depth of the posterior edge of the lateral intercondylar surface of the femur to the superficial part of the anterior edge(deep-shallow DS)and from the high part of the upper edge to the lower part of the lower edge(high-low HL),and the position of the tunnel of the tibia side was represented by the proportion site of the line connecting the anterior and posterior edge of the tibial plateau.Knee joint function score(Lysholm score,Tegner score)and knee joint stability(Lachman test,pivot shift test)were compared between the two groups before and 12 months after operation.Results All patients were followed up for more than 12 months,with an average of 16 months.The operation time of the control group was 56.3±1.6 min,and the operation time of the navigation group was 78.0±1.1)min(P <0.05).The operation time of the control group was significantly shorter than that of the control group.The results of tunnel location in the two groups showed that the proportion of DS in the femoral tunnel was(27.2 ±4.0)% in the navigation group and(34.1 ±4.6)% in the control group(P <0.05).The proportion of);HL in the navigation group and the control group was(36.5 ±5.3)% and(39.3 ±5.3)%,respectively.The proportion of the tibial tunnel at the anterior and posterior edge of the tibial plateau was(44.4 ±1.8)% in the navigation group and(44.7 ±2.9)% in the control group(P >0.05).The knee joint function(Lysholm score,Tegner score)and knee joint stability(Lachman test,pivot shift test)were significantly improved in the two groups at 12 months after operation.There was no significant difference in knee function score and knee joint stability between the two groups(P > 0.05).Conclusion Computer navigation system can improve the accuracy of lateral femoral tunnel location in anterior cruciate ligament reconstruction,but there is no significant difference in tibial tunnel location between the two groups.The computer navigation system increased the operation time,and satisfactory clinical results were obtained in both groups,but there was no significant difference in clinical effect between the two groups.