RT Journal
A1 Meuffels, Duncan E.
A1 Reijman, Max
A1 Verhaar, Jan A.N.
T1 Computer-Assisted Surgery Is Not More Accurate or Precise Than Conventional Arthroscopic ACL ReconstructionA Prospective Randomized Clinical Trial
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2012
FD September 5
VO 94
IS 17
SP 1538
OP 1545
DO 10.2106/JBJS.K.00878
UL http://dx.doi.org/10.2106/JBJS.K.00878
AB Background: 
  Accurate and precise tunnel placement is critical to the success of anterior cruciate ligament (ACL) reconstruction. A new development, computer-assisted surgery, aids in placement of the ACL bone tunnels during surgery. Our hypothesis was that computer-assisted ACL reconstruction would allow more accurate and precise tunnel placement compared with conventional surgery.Methods: 
  In a prospective, double-blind, randomized clinical study, 100 patients eligible for ACL reconstruction with a transtibial technique were stratified by surgeon and randomized to either conventional or computer-assisted surgery. Measurement of femoral and tibial tunnel placement with use of three-dimensional computed tomography (CT) was used as the primary outcome to compare conventional ACL surgery with computer-assisted surgery.Results: 
  The placement of the femoral tunnel did not differ between groups (mean, 39.7% of the proximal-distal distance on the intracondylar axis [Blumensaat line] in the conventional group compared with 39.0% in the computer-assisted surgery group; p = 0.70). The anterior-posterior positioning of the tibial tunnel on the tibial plateau also did not differ significantly (38.9% in the conventional group compared with 38.2% in the computer-assisted surgery group; p = 0.58). There was no significant difference in the precision of either the femoral or the tibial tunnel placement between the two groups.Conclusions: 
  There was no significant difference in either the accuracy or the precision of tunnel placement between conventional and computer-assisted ACL reconstruction.Level of Evidence: 
  Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.