Accuracy Analysis of a Novel Electromagnetic Navigation Procedure Versus a Standard Minimally Invasive Method for Arthroscopically Assisted Acromioclavicular Joint Reconstructions

TY - JOUR

T1 - Accuracy Analysis of a Novel Electromagnetic Navigation Procedure Versus a Standard Minimally Invasive Method for Arthroscopically Assisted Acromioclavicular Joint Reconstructions

AU - Hoffmann, Michael

AU - Schroeder, Malte

AU - Hartel, Maximilian

AU - Korecki, Michael

AU - Rueger, Johannes M

AU - Nüchtern, Jakob V.

AU - Lehmann, Wolfgang

AU - Petersen, Jan P

N1 - Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

PY - 2014/8/1

Y1 - 2014/8/1

N2 - PURPOSE: The aim of this cadaveric study was to evaluate the accuracy, feasibility, and operation time of a novel electromagnetic navigation system (ENS) and procedure for transclavicular-transcoracoid tunnel placement compared with a standard minimally invasive (SMI) reconstruction method for minimally invasive arthroscopically assisted anatomic acromioclavicular joint reconstruction.METHODS: Ten arthroscopically assisted electromagnetic-navigated transclavicular-transcoracoid drilling procedures and 10 SMI procedures were performed on 10 human cadavers using 2 TightRope reconstructions (Arthrex, Naples, FL) for each site. Postoperative computed tomography scans were acquired to determine tunnel placement accuracy. Optimal coracoid tunnel placement was defined according to the anatomic insertions of the trapezoid and conoid ligaments with the oblong button placed in a center-base position at the coracoid undersurface without cortical breach or fracture. Both reconstruction procedures were performed without fluoroscopy.RESULTS: Successful tunnel placement was accomplished in 98.8% using the ENS method and in 83.8% using the SMI procedure (P = .087). The mean overall operation time was 28.5 ± 6.6 minutes for the ENS method and 35.2 ± 3.9 minutes for the SMI method (P = .012). The ENS procedure required no directional readjustments or restarts. Drill misguidance with subsequent cortical breach occurred twice in the SMI group. In both groups no fractures were documented.CONCLUSIONS: In this descriptive laboratory study, both the ENS and the SMI techniques achieved the desired anatomic reconstruction. Compared with the SMI method, the ENS procedure showed higher accuracy, required a shorter operation time, and was associated with no complications.CLINICAL RELEVANCE: Length of surgery, drilling accuracy, and reduction of radiation exposure in acromioclavicular joint reconstruction procedures affect the safety of both patients and surgeons.

AB - PURPOSE: The aim of this cadaveric study was to evaluate the accuracy, feasibility, and operation time of a novel electromagnetic navigation system (ENS) and procedure for transclavicular-transcoracoid tunnel placement compared with a standard minimally invasive (SMI) reconstruction method for minimally invasive arthroscopically assisted anatomic acromioclavicular joint reconstruction.METHODS: Ten arthroscopically assisted electromagnetic-navigated transclavicular-transcoracoid drilling procedures and 10 SMI procedures were performed on 10 human cadavers using 2 TightRope reconstructions (Arthrex, Naples, FL) for each site. Postoperative computed tomography scans were acquired to determine tunnel placement accuracy. Optimal coracoid tunnel placement was defined according to the anatomic insertions of the trapezoid and conoid ligaments with the oblong button placed in a center-base position at the coracoid undersurface without cortical breach or fracture. Both reconstruction procedures were performed without fluoroscopy.RESULTS: Successful tunnel placement was accomplished in 98.8% using the ENS method and in 83.8% using the SMI procedure (P = .087). The mean overall operation time was 28.5 ± 6.6 minutes for the ENS method and 35.2 ± 3.9 minutes for the SMI method (P = .012). The ENS procedure required no directional readjustments or restarts. Drill misguidance with subsequent cortical breach occurred twice in the SMI group. In both groups no fractures were documented.CONCLUSIONS: In this descriptive laboratory study, both the ENS and the SMI techniques achieved the desired anatomic reconstruction. Compared with the SMI method, the ENS procedure showed higher accuracy, required a shorter operation time, and was associated with no complications.CLINICAL RELEVANCE: Length of surgery, drilling accuracy, and reduction of radiation exposure in acromioclavicular joint reconstruction procedures affect the safety of both patients and surgeons.

U2 - 10.1016/j.arthro.2014.03.011

DO - 10.1016/j.arthro.2014.03.011

M3 - SCORING: Journal article

C2 - 24814293

VL - 30

SP - 928

EP - 935

JO - ARTHROSCOPY

JF - ARTHROSCOPY

SN - 0749-8063

IS - 8

ER -