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Knee Surgery, Sports Traumatology, Arthroscopy

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01-06-2016 | Experimental Study

Arthroscopic image distortion—part II: the effect of lens angle and portal location in a 3D knee model

Authors: Yuichi Hoshino, Benjamin B. Rothrauff, Daniel Hensler, Freddie H. Fu, Volker Musahl

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 6/2016

Abstract

Purpose

Distortion in arthroscopic views can interfere with accurate graft placement in ACL reconstruction, yet the effect of arthroscopic lens angle and portal location on image distortion is unknown. The purpose of this study was to quantify the image distortion resulting from the use of angulated arthroscope lenses through multiple portals, thereby identifying the optimal parameters to minimize distortion.

Methods

A uniform grid of dots was attached to the lateral wall of the intercondylar notch of a Sawbones^® knee model. The inferior half of the lateral wall was divided equally along the distoproximal axis into three regions—shallow, central, and deep. Each region was imaged using five different arthroscopic configurations [0° arthroscope through anteromedial (AM) portal, 30° arthroscope through AM and anterolateral (AL) portals, 70° arthroscope through AM and AL portals]. For each configuration, the differences in magnification and deformity ratios between the three regions were calculated.

Results

Less than 100 % of central region magnification was observed in the deep region, while more than 100 % was found in the shallow region. The AL approach produced larger magnification errors in the shallow region, as compared to the AM approach. Deformity ratios less than 100 % were found with both 0° and 30° arthroscopes, whereas deformity ratios exceeding 100 % were found with 70° arthroscopes.

Conclusions

The least distorted and the most consistent image of the femoral ACL insertion is provided through the AM portal using either a 30° or 70° arthroscope lens. Surgeons should carefully select the arthroscope and portal to minimize image distortion and ensure accurate surgical procedure.

Aglietti P, Buzzi R, Giron F, Simeone AJV, Zaccherotti G (1997) Arthroscopic-assisted anterior cruciate ligament reconstruction with the central third patellar tendon: a 5-8-year follow-up. Knee Surg Sports Traumatol Arthrosc 5:138–144CrossRefPubMed

Araujo PH, van Eck CF, Macalena JA, Fu FH (2011) Advances in the three-portal technique for anatomical single- or double-bundle ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 19(8):1239–1242CrossRefPubMedPubMedCentral

Asari KV, Kumar S, Radhakrishnan D (1999) Technique of distortion correction in endoscopic images using a polynomial expansion. Med Biol Eng Comput 37:8–12CrossRefPubMed

Bedi A, Altchek DW (2009) The “footprint” anterior cruciate ligament technique an anatomic approach to anterior cruciate ligament reconstruction. Arthroscopy 25(10):1128–1138CrossRefPubMed

Chechik O, Amar E, Khashan M, Lador R, Eyal G, Gold A (2013) An international survey on anterior cruciate ligament reconstruction practices. Int Orthop 37(2):201–206CrossRefPubMedPubMedCentral

Cohen SB, Fu FH (2007) Three-portal technique for anterior cruciate ligament reconstruction: use of a central medial portal. Arthroscopy. 23(3):325.e1–5

Colombet P, Robinson J, Christel P, Franceschi JP, Djian P, Bellier G, Sbihi A (2006) Morphology of anterior cruciate ligament attachments for anatomic reconstruction: a cadaveric dissection and radiographic study. Arthroscopy 22(9):984–992CrossRefPubMed

Ferretti M, Ekdahl M, Shen W, Fu FH (2007) Osseous landmarks of the femoral attachment of the anterior cruciate ligament: an anatomic study. Arthroscopy 23(11):1218–1225CrossRefPubMed

Harner CD, Honkamp NJ, Ranawat AS (2008) Anteromedial portal technique for creating the anterior cruciate ligament femoral tunnel. Arthroscopy 24(1):113–115CrossRefPubMed

10.

Hensler D, Working ZM, Illingworth KD, Thorhauer ED, Tashman S, Fu FH (2011) Medial portal drilling: effects on the femoral tunnel aperture morphology during anterior cruciate ligament reconstruction. J Bone Joint Surg Am 93(22):2063–2071CrossRefPubMed

11.

Hoshino Y, Nagamune K, Yagi M, Araki D, Nishimoto K, Kubo S, Minoru D, Kurosaka M, Kuroda R (2009) The effect of intra-operative knee flexion angle on determination of graft location in the anatomic double-bundle anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 17:1052–1060CrossRefPubMed

12.

Hoshino Y, Rothrauff BB, Hensler D, Fu FH, Musahl V (2014) Arthroscopic image distortion—part I: the effect of lens and viewing angles in a 2-dimensional in vitro model. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-3336-3

13.

Insall J, Salvati E (1971) Patella position in the normal knee joint. Radiology 101(1):101–104CrossRefPubMed

14.

Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174CrossRefPubMed

15.

Purnell ML, Larson AI, Clancy W (2008) Anterior cruciate ligament insertions on the tibia and femur and their relationships to critical landmarks using high-resolution volume-rendering computed tomography. Am J Sports Med 36:2083–2090CrossRefPubMed

16.

Shino K, Horibe S, Hamada M, Nakamura N, Nakata K, Toritsuka Y, Mae T (2002) Allograft anterior cruciate ligament reconstruction. Tech Knee Surg 1:78–85CrossRef

17.

Siebolt R, Ellert T, Metz S, Metz J (2008) Femroal insertions of the anteromedial and posterolateral bundles of the anterior cruciate ligament: morphometry and arthroscopic orientation models for double-bundle bone tunnel placement: a cadaver study. Arthroscopy 24(5):585–592CrossRef

18.

Sommer C, Friederich NF, Muller W (2000) Improperly placed anterior cruciate ligament grafts: correlation between radiological parameters and clinical results. Knee Surg Sports Traumatol Arthrosc 8:207–213CrossRefPubMed

19.

Yasuda K, Kondo E, Ichiyama H, Kitamura N, Tanabe Y, Tohyama H, Minami A (2004) Anatomic reconstruction of the anteromedial and poterolateral bundles of the anterior cruciate ligament using hamstring tendon grafts. Arthroscopy 20(10):1015–1025CrossRefPubMed

20.

Zantop T, Haase AK, Fu FH, Petersen W (2008) Potential risk of cartilage damage in double bundle ACL reconstruction: impact of knee flexion angle and portal location on the femoral PL bundle tunnel. Arch Orthop Trauma Surg 128(5):509–513CrossRefPubMed

21.

Zantop T, Wellmann M, Fu FH, Petersen W (2008) Tunnel positioning of anteromedial and posterolateral bundles in anatomic anterior cruciate ligament reconstruction: anatomic and radiographic findings. Am J Sports Med 36(1):65–72CrossRefPubMed

Title: Arthroscopic image distortion—part II: the effect of lens angle and portal location in a 3D knee model
Authors: Yuichi Hoshino
Benjamin B. Rothrauff
Daniel Hensler
Freddie H. Fu
Volker Musahl
Publication date: 01-06-2016
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 6/2016
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-014-3268-y

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Springer Medicine

Arthroscopic image distortion—part II: the effect of lens angle and portal location in a 3D knee model

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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