Visualization of postoperative anterior cruciate ligament reconstruction bone tunnels Reliability of standard radiographs, CT scans, and 3D virtual reality images

Duncan Meuffels, Jan-willem Potters, Anton Koning, CH Brown, Jan Verhaar, Max Reijman

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Background and purpose Non-anatomic bone tunnel placement is the most common cause of a failed ACL reconstruction. Accurate and reproducible methods to visualize and document bone tunnel placement are therefore important. We evaluated the reliability of standard radiographs, CT scans, and a 3-dimensional (3D) virtual reality (VR) approach in visualizing and measuring ACL reconstruction bone tunnel placement. Methods 50 consecutive patients who underwent single-bundle ACL reconstructions were evaluated postoperatively by standard radiographs, CT scans, and 3D VR images. Tibial and femoral tunnel positions were measured by 2 observers using the traditional methods of Amis, Aglietti, Hoser, Staubli, and the method of Benereau for the VR approach. Results The tunnel was visualized in 50-82% of the standard radiographs and in 100% of the CT scans and 3D VR images. Using the intraclass correlation coefficient (ICC), the inter-and intraobserver agreement was between 0.39 and 0.83 for the standard femoral and tibial radiographs. CT scans showed an ICC range of 0.49-0.76 for the inter-and intraobserver agreement. The agreement in 3D VR was almost perfect, with an ICC of 0.83 for the femur and 0.95 for the tibia. Interpretation CT scans and 3D VR images are more reliable in assessing postoperative bone tunnel placement following ACL reconstruction than standard radiographs.
Original languageUndefined/Unknown
Pages (from-to)699-703
Number of pages5
JournalActa Orthopaedica
Issue number6
Publication statusPublished - 2011

Research programs

  • EMC MGC-02-02-01
  • EMC MM-01-51-01

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