Skip to main content
SpringerLink
Log in

Navigation for Revision ACL Reconstruction

  • Chapter
  • First Online:
Revision ACL Reconstruction

  • 2211 Accesses

Abstract

Revision reconstruction of the anterior cruciate ligament (ACL) is becoming more frequent due to the increasing number of ACL primary reconstruction combined with the high level of activity expected by the patients. In the revision ACL reconstruction, there are many technical issues, like bone tunnel defects or incorrect tunnel placement, that influence negatively the result compared with primary procedures. Computer-aided surgery (CAS) can enable the surgeon to improve the outcome and to detect causes for failure of the primary reconstruction. The purpose of this chapter is to describe an approach to ACL revision surgery using a commercial navigation system (BLU-IGS, Orthokey LLC, Lewes, De, USA) to intra-operatively measure joint laxity, graft elongations, isometry maps, and previous tunnel placement. This technique allows to evaluate joint kinematics and laxities before performing the ACL revision, to check the placement and the isometry of the new tunnels. Further, navigated surgery allows to test in real-time the efficacy of the reconstruction and to search for any possible associated secondary laxity. Advantages of CAS are especially important for complex scenarios as ACL revision surgery, due to the improvement of the accuracy that may potentially allow to customize the surgery for each patient to reduce the failures.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Eberhardt C, Kurth AH, Hailer N, Jäger A. Revision ACL reconstruction using autogenous patellar tendon graft. Knee Surg Sports Traumatol Arthrosc. 2000; 8(5):290–5.

    Article  PubMed  CAS  Google Scholar 

  2. Grossman MG, ElAttrache NS, Shields CL, Glousman RE. Revision anterior cruciate ligament reconstruction: three- to nine-year follow-up. Arthroscopy. 2005;21(4):418–23.

    Article  PubMed  Google Scholar 

  3. Noyes FR, Barber-Westin SD. Revision anterior cruciate surgery with use of bone-patellar tendon-bone autogenous grafts. J Bone Joint Surg Am. 2001; 83-A(8):1131–43.

    PubMed  CAS  Google Scholar 

  4. Uribe JW, Hechtman KS, Zvijac JE, Tjin-A-Tsoi EW. Revision anterior cruciate ligament surgery: experience from Miami. Clin Orthop Relat Res. 1996;325: 91–9.

    Article  PubMed  Google Scholar 

  5. Yagi M, Kuroda R, Nagamune K, Yoshiya S, Kurosaka M. Double-bundle ACL reconstruction can improve rotational stability. Clin Orthop Relat Res. 2007;454: 100–7.

    Article  PubMed  Google Scholar 

  6. Carson EW, Anisko EM, Restrepo C, et al. Revision anterior cruciate ligament reconstruction: etiology of failures and clinical results. J Knee Surg. 2004;17(3): 127–32.

    PubMed  Google Scholar 

  7. Johnson DL, Swenson TM, Irrgang JJ, Fu FH, Harner CD. Revision anterior cruciate ligament surgery: experience from Pittsburgh. Clin Orthop Relat Res. 1996;325:100–9.

    Article  PubMed  Google Scholar 

  8. Noyes FR, Barber-Westin SD. Revision anterior cruciate ligament surgery: experience from Cincinnati. Clin Orthop Relat Res. 1996;325:116–29.

    Article  PubMed  Google Scholar 

  9. Taggart TF, Kumar A, Bickerstaff DR. Revision anterior cruciate ligament reconstruction: a midterm patient assessment. Knee. 2004;11(1):29–36.

    Article  PubMed  CAS  Google Scholar 

  10. Texier A, Hulet C, Acquitter Y, et al. [Arthroscopy-assisted revision in failed reconstruction of anterior cruciate ligament: 32 cases]. Rev Chir Orthop Reparatrice Appar Mot. 2001;87(7):653–60.

    PubMed  CAS  Google Scholar 

  11. Dennis DA, Mahfouz MR, Komistek RD, Hoff W. In vivo determination of normal and anterior cruciate ligament-deficient knee kinematics. J Biomech. 2005;38(2):241–53.

    Article  PubMed  Google Scholar 

  12. Fu FH, Harner CD, Johnson DL, Miller MD, Woo SL. Biomechanics of knee ligaments: basic concepts and clinical application. Instr Course Lect. 1994;43: 137–48.

    PubMed  CAS  Google Scholar 

  13. Jackson DW, Simon TM. History of computer-assisted orthopedic surgery (CAOS) in sports medicine. Sports Med Arthrosc. 2008;16(2):62–6.

    Article  PubMed  Google Scholar 

  14. Schep NWL, Broeders IAMJ, van der Werken C. Computer assisted orthopaedic and trauma surgery. State of the art and future perspectives. Injury. 2003;34(4):299–306.

    Article  PubMed  CAS  Google Scholar 

  15. Koh JL. The future of computer-assisted surgery (CAS) in sports medicine. Sports Med Arthrosc. 2008;16(2):108–10.

    Article  PubMed  Google Scholar 

  16. Sikorski JM, Chauhan S. Computer-assisted orthopaedic surgery: do we need CAOS? J Bone Joint Surg Br. 2003;85(3):319–23.

    Article  PubMed  CAS  Google Scholar 

  17. Kodali P, Yang S, Koh J. Computer-assisted surgery for anterior cruciate ligament reconstruction. Sports Med Arthrosc. 2008;16(2):67–76.

    Article  PubMed  Google Scholar 

  18. Nakagawa T, Hiraoka H, Fukuda A, et al. Fluoroscopic-based navigation-assisted placement of the tibial tunnel in revision anterior cruciate ligament reconstruction. Arthroscopy. 2007;23(4):443.e1–e4.

    Article  Google Scholar 

  19. Marcacci M, Zaffagnini S, Bonanzinga T, et al. Over-the-top double-bundle revision ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 2012;20: 1404–8. Available at: http://www.ncbi.nlm.nih.gov/pubmed/22057386.

    Google Scholar 

  20. Martelli S, Lopomo N, Bignozzi S, Zaffagnini S, Visani A. Validation of a new protocol for navigated intraoperative assessment of knee kinematics. Comput Biol Med. 2007;37(6):872–8.

    Article  PubMed  Google Scholar 

  21. Martelli S, Lopomo N, Greggio S, Ferretti E, Visani A. Development and applications of a software tool for diarthrodial joint analysis. Comput Methods Programs Biomed. 2006;83(1):50–6.

    Article  PubMed  Google Scholar 

  22. Zaffagnini S, Bignozzi S, Martelli S, et al. New intraoperative protocol for kinematic evaluation of ACL reconstruction: preliminary results. Knee Surg Sports Traumatol Arthrosc. 2006;14(9):811–6.

    Article  PubMed  CAS  Google Scholar 

  23. Zaffagnini S, Bignozzi S, Martelli S, Lopomo N, Marcacci M. Does ACL reconstruction restore knee stability in combined lesions?: an in vivo study. Clin Orthop Relat Res. 2007;454:95–9.

    Article  PubMed  Google Scholar 

  24. Lopomo N, Zaffagnini S, Bignozzi S, Visani A, Marcacci M. Pivot-shift test: analysis and quantification of knee laxity parameters using a navigation system. J Orthop Res. 2010;28(2):164–9.

    PubMed  Google Scholar 

  25. Martelli S, Zaffagnini S, Falcioni B, Motta M. Determination of an optimal kinematic protocol for computer-assisted evaluation of anterior cruciate ligament deficiency. Ann Biomed Eng. 2001;29(12):1112–21.

    Article  PubMed  CAS  Google Scholar 

  26. Zaffagnini S, Martelli S, Falcioni B, Motta M, Marcacci M. Rotational laxity after anterior cruciate ligament injury by kinematic evaluation of clinical tests. J Med Eng Technol. 2000;24(5):230–6.

    Article  PubMed  CAS  Google Scholar 

  27. Marcacci M, Zaffagnini S, Iacono F, et al. Arthroscopic intra- and extra-articular anterior cruciate ligament reconstruction with gracilis and semitendinosus tendons. Knee Surg Sports Traumatol Arthrosc. 1998; 6(2):68–75.

    Article  PubMed  CAS  Google Scholar 

  28. Daniel DM, Malcom LL, Losse G, et al. Instrumented measurement of anterior laxity of the knee. J Bone Joint Surg Am. 1985;67(5):720–6.

    PubMed  CAS  Google Scholar 

  29. Colombet P. Knee laxity control in revision anterior cruciate ligament reconstruction versus anterior cruciate ligament reconstruction and lateral tenodesis: clinical assessment using computer-assisted navigation. Am J Sports Med. 2011;39(6):1248–54.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Clinica Ortopedica e Traumatologica III/Laboratorio di Biomeccanica e Innovazione Tecnologica, Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, 40136, Bologna, Italy

    Stefano Zaffagnini MD, Tommaso Bonanzinga MD, Giulio Maria Marcheggiani Muccioli MD & Maurilio Marcacci MD

  2. Department of Orthopedics, Singapore General Hospital, Outram Park, Singapore

    Bharat Sharma MBBS, DNB (Ortho)

  3. Laboratorio di Biomeccanica ed Innovazione Tecnologica, Istituto Ortopedico Rizzoli, Bologna, Italy

    Nicola Lopomo PhD

  4. Laboratorio di Biomeccanica e Innovazione Tecnologia, Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, 40136, Bologna, Italy

    Cecilia Signorelli MSc

  5. Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Via Golgi 39, 20133, Milano, Italy

    Cecilia Signorelli MSc

Authors
  1. Stefano Zaffagnini MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tommaso Bonanzinga MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bharat Sharma MBBS, DNB (Ortho)
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nicola Lopomo PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Cecilia Signorelli MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Giulio Maria Marcheggiani Muccioli MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Maurilio Marcacci MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stefano Zaffagnini MD .

Editor information

Editors and Affiliations

  1. Orthopaedic Surgery, Hospital for Special Surgery Weill Cornell Medical College, New York, New York, USA

    Robert G. Marx

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Zaffagnini, S. et al. (2014). Navigation for Revision ACL Reconstruction. In: Marx, R. (eds) Revision ACL Reconstruction. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-0766-9_23

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-0766-9_23

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-0765-2

  • Online ISBN: 978-1-4614-0766-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation