Chinese Journal of Tissue Engineering Research ›› 2011, Vol. 15 ›› Issue (17): 3139-3142.doi: 10.3969/j.issn.1673-8225.2011.17.024

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Application of computer navigation system in tibial tunnel positioning during reconstruction of posterior cruciate ligament

Xiong Jian-bin, Zhao Jin-min, Sha Ke, Cheng Jian-wen, Wei Qing-jun   

  1. Fifth Affiliated Hospital of Guangxi Medical University (People’s Hospital of Liuzhou), Liuzhou  545000, Guangxi Zhuang Autonomous Region, China
  • Received:2010-11-21 Revised:2011-02-07 Online:2011-04-23 Published:2011-04-23
  • Contact: Wei Qing-jun, Associate chief physician, Master’s supervisor, Fifth Affiliated Hospital of Guangxi Medical University (People’s Hospital of Liuzhou), Liuzhou 545000, Guangxi Zhuang Autonomous Region, China weiqingjungxnn@163.com
  • About author:Xiong Jian-bin★, Master, Fifth Affiliated Hospital of Guangxi Medical University (People’s Hospital of Liuzhou), Liuzhou 545000, Guangxi Zhuang Autonomous Region, China xiongjianbin@163.com
  • Supported by:

    Medical Science and Technology Program of Guangxi Provincial Health Bureau in 2008, No. 200835*

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Abstract:

BACKGROUND: Positioning pathway of bony tunnel in tibia during reconstructing posterior cruciate ligament is a difficult part of surgical procedure permanently. As computer assistant navigating system applied in the field of medicine rapidly, we use this technique to elevate accuracy of positioning bony tunnel in tibia and improve the operative effect in reconstruction of posterior cruciate ligament.
OBJECTIVE: To investigate the rational plan of computer navigation system in the reconstruction of posterior cruciate ligament and the accurate positioning methods of tibial tunnel, and to evaluate the application of computer navigation system in the reconstruction of posterior cruciate ligament. 
METHODS: Fifty adult lower limb specimens were collected and randomly divided into two groups, each 25 specimens. The computer navigation system and the traditional arthroscopy system were respectively used for positioning the tibial tunnel reconstructed by adult posterior cruciate ligament. The exit position of tibial tunnel was observed in two groups, the angle between tunnel and the articular surface of tibia was measured through sagittal plane, and the number of fluoroscopy was recorded.
RESULTS AND CONCLUSION: There were no difference between fictitious tunnel angle and virtual tunnel angle (P > 0.05). X-ray at side position showed: the tibial tunnel angle in non-navigation group was (52.63±1.04)°, and that in navigation group was (61.88±0.94)°. The tibial tunnel angle in navigation group was more than 60°, which could effectively avoid the killer turning effect. There were 23 cases of tibial tunnel exit position in effective planned region in navigation group and there were only 15 cases in non-navigation group, which showed that the exit position of tibial tunnel oriented by computer navigation system was closer to the physical insertion point. The fluoroscopy number of navigation groups was 3±0.5, that in non-navigation group was 9±2.7. There were little radiation and surgery pollution in navigation group. Fluoro-based navigation technique could be used for assisting tibial tunnel placement in arthroscopic posterior cruciate ligament reconstruction. It had characteristics such as accurate and reasonable tunnel placement and saving fluoroscopy time.

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