2017 ISAKOS Biennial Congress ePoster #1018

 

Computer Assisted Anterior Cruciate Ligament Reconstruction Versus Conventional Arthroscopic Anterior Cruciate Ligament Reconstruction: A Prospective Randomized Clinical Trial with 2-Year Follow-Up

Duncan E. Meuffels, MD, PhD, Rotterdam NETHERLANDS
Max Reijman, PhD, Benthuizen NETHERLANDS
Erasmus MC, University Medical Centre Rotterdam, Rotterdam, NETHERLANDS

FDA Status Not Applicable

Summary

There is no significant clinical advantage using CAS ACL reconstruction compared to conventional ACL reconstruction. This study showed no significant relationship between 3-D CT tunnel placement and clinical outcome at 2-year follow-up.

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Abstract

Background

Accurate and precise tunnel placement is critical to the success of anterior cruciate ligament (ACL) reconstruction. A new development has been computer assisted surgery (CAS), aiding in the ACL bone tunnel placement during surgery and 3-D computer tomography (CT) imaging of the tunnelpositioning of the ACL reconstruction.

Hypothesis

Using CAS for ACL surgery will improve clinical outcome compared to conventional surgery.
Study design: This study is set up as a prospective double-blinded randomized clinical study www.controlled-trials.com/ISRCTN40231111.

Methods

100 patients eligible for ACL reconstruction were stratified per surgeon and randomized for either conventional or CAS. Patients were seen at 6 weeks, 3,6,9,12 and 24 months post-operatively and IKDC, KOOS, Lysholm and Tegner was scored. 3-D CT tunnelplacement was compared to clinical outcome data.

Results

The results of this randomized, controlled trial showed no significant difference in clinical outcome at two year follow up between CAS versus conventional ACL reconstruction. IKDC for the CAS group showed a mean of 85.0 (95% CI 55.8-100) versus 85.8 (95% CI 58.8-100) for the conventional ACL reconstruction. KOOS and Lysholm showed no significant difference comparing the CAS ACL reconstructed group with conventional ACL reconstruction. The activity level for both groups at two years showed a mean of 7. The variance of the tibia and femur tunnel aperture measurements in each randomization group was calculated separately. These were compared using Levene’s test. We also compared the achieved position for both groups in two dimensions for the femoral and the tibial tunnel aperture. No correlation was found between the 3-D CT aperture position and clinical outcome (KOOS, IKDC, laxity, failures/reruptures).

Conclusions

There is no significant clinical advantage using CAS ACL reconstruction compared to conventional ACL reconstruction. This study showed no significant relationship between 3-D CT tunnel placement and clinical outcome at 2-year follow-up.

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