caa a22 4500 605457069 CHVBK 20210128100221.0 cr unu---uuuuu 210128e20150701xx s 000 0 eng 10.1007/s00167-014-2963-z doi (NATIONALLICENCE)springer-10.1007/s00167-014-2963-z Variability of landmark acquisition affects tunnel calculation in image-free ACL navigation [Elektronische Daten] [Sven Shafizadeh, Maurice Balke, Ulrich Hagn, Stefan Grote, Bertil Bouillon, Marc Banerjee] Purpose: The purpose of this study was to determine the inter- and intraobserver variability of intraarticular landmark identification for tunnel position calculation in image-free anterior cruciate ligament (ACL) navigation. Methods: In a test/retest scenario, thirteen experienced ACL surgeons (>50 reconstructions year) experienced in image-free ACL navigation were asked to identify the landmarks required for image-free ACL navigation in the same cadaver knee. Landmark positions were registered using a fluoroscopic ACL navigation system. Positions were determined using validated radiological measurement methods. For variability analysis, mean positions, deviations between the test/retest positions, standard deviations (SD) and range were calculated. Results: Interobserver analysis showed a mean variability (SD) for the tibial landmark positions of 3.0mm with deviations of up to 24.3mm (range). Mean femoral landmark variability was 2.9mm (SD) with deviations of up to 11.3mm (range). Intraobserver analysis showed a tibial reproducibility of 2.2mm (SD 2.0mm; range 10.9mm) and a femoral of 1.9mm (SD 1.9mm; range 10.4mm). Conclusion: The data of the presented study suggest that a considerable inter- and intraobserver variability in intraarticular landmark identification exists. Reasonable ranges were found that have to be considered as a potential risk for miscalculation of tunnel positions in image-free ACL reconstruction. Clinical relevance: Landmark acquisition affects tunnel calculation in image-free ACL. Level of evidence: IV. Springer-Verlag Berlin Heidelberg, 2014 ACL nationallicence Tunnel positions nationallicence Navigation nationallicence Variability nationallicence Landmark acquisition nationallicence Shafizadeh Sven Department of Trauma and Orthopaedic Surgery, Cologne Merheim Medical Centre, Witten/Herdecke University, Ostmerheimer Strasse 200, 51109, Cologne, Germany aut Balke Maurice Department of Trauma and Orthopaedic Surgery, Cologne Merheim Medical Centre, Witten/Herdecke University, Ostmerheimer Strasse 200, 51109, Cologne, Germany aut Hagn Ulrich Department of Surgery, Hospital Cologne-Porz, Urbacherweg 19, 51149, Cologne, Germany aut Grote Stefan Department of Trauma, Hand and Reconstructive Surgery, Grosshadern Hospital Munich, Ludwig Maximilian University Munich, Marchioninistraße 15, 81377, Munich, Germany aut Bouillon Bertil Department of Trauma and Orthopaedic Surgery, Cologne Merheim Medical Centre, Witten/Herdecke University, Ostmerheimer Strasse 200, 51109, Cologne, Germany aut Banerjee Marc Department of Trauma and Orthopaedic Surgery, Cologne Merheim Medical Centre, Witten/Herdecke University, Ostmerheimer Strasse 200, 51109, Cologne, Germany aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/7(2015-07-01), 1917-1924 0942-2056 23:7<1917 2015 23 167 https://doi.org/10.1007/s00167-014-2963-z text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-014-2963-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Shafizadeh Sven Department of Trauma and Orthopaedic Surgery, Cologne Merheim Medical Centre, Witten/Herdecke University, Ostmerheimer Strasse 200, 51109, Cologne, Germany aut NATIONALLICENCE 700 1- Balke Maurice Department of Trauma and Orthopaedic Surgery, Cologne Merheim Medical Centre, Witten/Herdecke University, Ostmerheimer Strasse 200, 51109, Cologne, Germany aut NATIONALLICENCE 700 1- Hagn Ulrich Department of Surgery, Hospital Cologne-Porz, Urbacherweg 19, 51149, Cologne, Germany aut NATIONALLICENCE 700 1- Grote Stefan Department of Trauma, Hand and Reconstructive Surgery, Grosshadern Hospital Munich, Ludwig Maximilian University Munich, Marchioninistraße 15, 81377, Munich, Germany aut NATIONALLICENCE 700 1- Bouillon Bertil Department of Trauma and Orthopaedic Surgery, Cologne Merheim Medical Centre, Witten/Herdecke University, Ostmerheimer Strasse 200, 51109, Cologne, Germany aut NATIONALLICENCE 700 1- Banerjee Marc Department of Trauma and Orthopaedic Surgery, Cologne Merheim Medical Centre, Witten/Herdecke University, Ostmerheimer Strasse 200, 51109, Cologne, Germany aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/7(2015-07-01), 1917-1924 0942-2056 23:7<1917 2015 23 167