{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T16:24:06Z","timestamp":1771863846844,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2016,10,19]],"date-time":"2016-10-19T00:00:00Z","timestamp":1476835200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2016,10,19]],"date-time":"2016-10-19T00:00:00Z","timestamp":1476835200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To evaluate the clinical advantages of a navigation system developed with an emphasis on attaining an appropriate femoral tunnel length and posterior wall margin with no posterior wall blowout, as well as having accurate tunnel positioning, in anatomical anterior cruciate ligament reconstruction (ACLR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ten freshly frozen human knees were transected at mid\u2010femur and mid\u2010tibia. Each knee specimen underwent arthroscopic single\u2010bundle anterior cruciate ligament reconstruction using the outside\u2010in technique, with two knees by manual ACLR (control group) and another eight knees by only the navigational ACLR without arthroscopic assistance (experimental group). The position\/orientation information of tunnel entry point, tunnel length, and posterior wall distance of pre\u2010, intra\u2010, and postoperative tunnel were recorded, and the reliability and errors among them were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From comparison of the 3D models for preoperative planning and postoperative reconstruction, the mean differences for navigational femoral tunnelling and arthroscopic\u2010assisted femoral tunnelling were recorded, respectively: (1) tunnel entry position, 1.4\u00a0mm (SD 0.3) versus 4.9\u00a0mm; (2) tunnel length, 0.7\u00a0mm (SD 0.2), similar to 0.6\u00a0mm in arthroscopic\u2010assisted femoral tunnelling, and (3) posterior wall distance, 0.5\u00a0mm (SD 0.2), much smaller than 4.7\u00a0mm for arthroscopic\u2010assisted femoral tunnelling. The intraclass correlation coefficients, calculated to determine the accuracy and reliability of navigational femoral tunnelling, showed excellent internal consistency that ranged from 0.965 to 0.989 for tunnel length and from 0.810 to 0.953 for posterior wall distance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Navigation systems with enhancement of the registration accuracy by the developed system are feasible in anatomical ACLR, in reducing surgical failures such as short tunnel length or posterior wall breakage of distal femur. The present study revealed that computer navigation could aid in avoiding major mistakes in exact positioning and posterior wall blowout and help in attaining appropriate length for femoral tunnelling in anatomical ACLR.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-016-4332-6","type":"journal-article","created":{"date-parts":[[2016,10,19]],"date-time":"2016-10-19T00:48:45Z","timestamp":1476838125000},"page":"3556-3564","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Clinical advantages of image\u2010free navigation system using surface\u2010based registration in anatomical anterior cruciate ligament reconstruction"],"prefix":"10.1002","volume":"24","author":[{"given":"Byung Hoon","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Kang\u2010Dong Sacred Heart Hospital Hallym University Medical Center 134\u2010701 Gil\u2010dong, Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong Ho","family":"Kum","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Samsung Medical Center Sungkyunkwan University School of Medicine 81 Irwon\u2010ro, Gangnam\u2010gu 135\u2010710 Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Im Joo","family":"Rhyu","sequence":"additional","affiliation":[{"name":"Department of Anatomy College of Medicine Korea University Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youngjun","family":"Kim","sequence":"additional","affiliation":[{"name":"Center for Bionics Korea Institute of Science and Technology Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyunchul","family":"Cho","sequence":"additional","affiliation":[{"name":"Center for Bionics Korea Institute of Science and Technology Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joon Ho","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Samsung Medical Center Sungkyunkwan University School of Medicine 81 Irwon\u2010ro, Gangnam\u2010gu 135\u2010710 Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,10,19]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01553517"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1807\u201059322010000700006"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510388157"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2011.03.079"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010013\u20102666\u2010x"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1248210"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010012\u20101961\u20102"},{"key":"e_1_2_7_9_1","first-page":"245","article-title":"Computer\u2010navigated ACL reconstruction with the OrthoPilot","volume":"12","author":"Degenhart M","year":"2004","journal-title":"Surg Technol Int"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2007.09.008"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.5435\/00124635\u2010199905000\u201000005"},{"key":"e_1_2_7_12_1","first-page":"463","article-title":"Evaluation and treatment of recurrent instability after anterior cruciate ligament reconstruction","volume":"50","author":"Harner CD","year":"2001","journal-title":"Instr Course Lect"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2009.02.013"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1302\/2046\u20103758.110.2000086"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.csm.2008.08.010"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513500626"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/JSA.0000000000000052"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/JSA.0b013e318175d189"},{"key":"e_1_2_7_19_1","first-page":"S122","article-title":"Anterior cruciate ligament (ACL) tunnel placement: a radiographic comparison between navigated versus manual ACL reconstruction","volume":"29","author":"Koh J","year":"2006","journal-title":"Orthopedics"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001670050216"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514538958"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2008.10.012"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010013\u20102831\u20102"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0b013e3181915bd7"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513490657"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.H.01553"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.3109\/10929080109146093"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2012.07.001"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2005.05.005"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2004.12.007"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010014\u20102963\u2010z"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509340407"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010013\u20102663\u20100"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.5792\/ksrr.2014.26.3.168"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.94B9.28250"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2009.09.018"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-016-4332-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00167-016-4332-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-016-4332-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00167-016-4332-6","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T13:50:35Z","timestamp":1760881835000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1007\/s00167-016-4332-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,10,19]]},"references-count":35,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2016,11]]}},"alternative-id":["10.1007\/s00167-016-4332-6"],"URL":"https:\/\/doi.org\/10.1007\/s00167-016-4332-6","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,10,19]]}}}