The role of navigation systems in ACL reconstruction

Experienced surgeons are skilled in accurate placement of bone tunnels into the native ACL footprint by using a variety of intra-articular landmarks (such as the resident’s ridge) as reference points without employing navigation systems. However, navigation systems can provide surgeons with a wide variety of data in real time that cannot be obtained under arthroscopic observation. In fact, navigation systems are useful tools for the objective assessment of the tunnel position as well as for the measurement of knee preoperative and postoperative laxity and kinematics. They also serve as an educational tool for less experienced surgeons. This chapter will introduce you computer-assisted ACL reconstruction surgery and its principal uses including tunnel positioning and its important contribution assessing joint laxities and the controlling effect of different surgical techniques used to treat ACL-deficient knees. A number of investigators have reported their experience with navigation-assisted ACL reconstruction surgery and their findings will be discussed. We will focus on the most relevant and latest published articles about navigation in ACL surgery. Finally, clinical outcomes when using navigation systems will be discussed.