Fluoro-Free navigated retrograde drilling of osteochondral lesions
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Florian Gras • Ivan Marintschev • David M. Kahler • Kajetan Klos • Thomas Mu¨ckley • Gunther O. Hofmann
- چاپ و سال / کشور: 2010
Description
Purpose Retrograde drilling of osteochondral lesions (OCLs) is a recommended, but demanding operative approach for revascularization of lesions in stage 1–3 according to Berndt and Harty after failed conservative treatment. The gold standard of intraoperative driller guidance is fluoroscopic control. Limitations are a 2D visualization of a 3D procedure and sometimes limited view of the OCL in fluoroscopy, leading to increased radiation exposure. A new image-free navigation procedure was evaluated for practicability and precision in first clinical applications. Methods In a period of 7 months, retrograde drillings were performed in eight patients (3x femoral condyle, 5x talus) using the new Fluoro-Free navigation procedure without rigidly fixed reference bases. Results In total, 29 retrograde drillings were performed without any technical problem. The overall mean operating time was 82.1 ± 29.3 min (34.6 ± 6.4 min for the standard arthroscopy and 11.2 ± 1.2 min per drill). Twenty-seven of 29 drillings hit the target with a 100% first-pass accuracy. Two complications during drilling (one navigation specific and one navigation independent) were observed. Conclusion The paper describes the promising first clinical applications of a new Fluoro-Free navigation procedure for the retrograde drilling of OCLs determined by arthroscopy. The benefit of that navigated drillings with a high rate of first-pass accuracy and no need for radiation exposure in contrast to standard techniques is highlighted
Knee Surg Sports Traumatol Arthrosc (2011) 19:55–59 DOI 10.1007/s00167-010-1260-8 Received: 27 March 2010 / Accepted: 24 August 2010 / Published online: 7 October 2010
