Anatomische reconstructie op basis van een dubbele-bundel techniek van de voorste kruisbanden met een computer-gestuurd chirurgisch systeem
01 / 1999 - 12 / 2003
- Purpose: Functional anatomy of the ACL (anterior cruciate ligaments) shows that two portions (anteromedial (AMB) and posterolateral (PLB)) stabilize the knee in flexion and near extension. Current single-bundle techniques cannot restore these two portions, and, therefore, complete restoration of knee stability is not possible. The project has two parts: 1. Defining the ACL insertion with respect to AMB and PLB. 2. Test a two-bundle reconstruction in comparison to the currently used single- bundle reconstruction. The in vitro experiments will be performed with computer-assisted surgery in order to obtain reproducible reconstructions. - Methodology: Thirty knee specimens were dissected. The AMB and PLB insertion sites were marked and measured with Fast Track (3D). From these data, a template of the insertion was made for the computer-assisted surgery system. A reconstruction method was designed for the two bundles with quadriceps tendon. Ten cadaver knees were tested in a special frame with intact ACL, with the ACL cut, with a double-bundle ACL reconstruction and a single-bundle reconstruction. The drill holes for the ligaments were positioned with CAS. - Progress: The anatomy part of the study is finished. The template has been incorporated in a computer-assisted system. The in vitro experiments with anatomic double-bundle and isometric single-bundle ACL-reconstruction have been performed. A validation study for the developed template is planned and a radiological anatomy study is ongoing.