Journal article
Surgically oriented measurements for three-dimensional characterization of tunnel placement in anterior cruciate ligament reconstruction
Computer aided surgery (New York, N.Y.), Vol.17(5), pp.221-231
09/01/2012
DOI: 10.3109/10929088.2012.707230
PMID: 22897356
Abstract
Objective: To develop and evaluate the feasibility and reliability of an alternative three-dimensional (3D) measurement system capable of characterizing tunnel position and orientation in ACL reconstructed knees.
Methods: We developed a surgically oriented 3D measurement system for characterizing femoral and tibial drill tunnels from ACL reconstructions. This is accomplished by simulating the positioning of the drill bit originally used to create the tunnels within the bone, which allows for angular and spatial descriptions along defined axes that are established with respect to previously described anatomic landmarks and radiographic views. Computer-generated digital phantoms composed of simplified geometries were used to verify proper calculation of angular and spatial measurements. We also evaluated the inter-observer reliability of the measurements using 10 surfaces generated from cadaveric knees in which ACL tunnels were drilled. The reliability of the measurements was evaluated by intraclass correlation coefficients.
Results: The digital phantom evaluation verified the measurement methods by computing angular and spatial values that matched the known values in all cases. The intraclass correlation coefficient was calculated for four users and was found to range from 0.95 to 0.99 for the femoral and tibial measurements, demonstrating near-perfect agreement.
Conclusions: The characterization of ACL tunnels has historically concentrated on two-dimensional (2D) measurements; however, it can be difficult to define ACL tunnel placement using 2D methods. We have presented novel techniques for defining graft tunnel placement from 3D surface representations of the ACL reconstructed knee. These measurements provide exact tunnel location spatially and along axes that offer the potential to comparatively analyze ACL reconstructions post-operatively using advanced imaging. These methods are reliable, and have been demonstrated to be applicable to multiple single-bundle techniques for ACL reconstruction.
Details
- Title: Subtitle
- Surgically oriented measurements for three-dimensional characterization of tunnel placement in anterior cruciate ligament reconstruction
- Creators
- Austin J Ramme - Center for Computer-Aided Design, The University of IowaBrian R Wolf - Department of Orthopaedics and Rehabilitation, The University of IowaBryan A Warme - Department of Orthopaedics and Rehabilitation, The University of IowaKiran H Shivanna - Center for Computer-Aided Design, The University of IowaMichael C Willey - Department of Orthopaedics and Rehabilitation, The University of IowaCarla L Britton - Department of Orthopaedics and Rehabilitation, The University of IowaVincent A Magnotta - Department of Radiology, The University of IowaNicole M Grosland - Department of Orthopaedics and Rehabilitation, The University of Iowa
- Resource Type
- Journal article
- Publication Details
- Computer aided surgery (New York, N.Y.), Vol.17(5), pp.221-231
- DOI
- 10.3109/10929088.2012.707230
- PMID
- 22897356
- NLM abbreviation
- Comput Aided Surg
- ISSN
- 1092-9088
- eISSN
- 1097-0150
- Publisher
- Taylor & Francis
- Language
- English
- Date published
- 09/01/2012
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Psychiatry; Iowa Neuroscience Institute; Orthopedics and Rehabilitation; Physical Therapy and Rehabilitation Science; Injury Prevention Research Center
- Record Identifier
- 9984040283002771
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