3D Anatomy Versus Arthroscopy Versus Navigation

Computer-assisted surgery (CAS) has been extensively used over the course of the last few decades. At present, ligaments surgery—with great care to anterior cruciate ligament (ACL) injury—and joint arthroplasty represent the major field of application in orthopaedics. The first step in using CAS technology for knee surgery was addressed to improve the accuracy of the intervention (limb alignment or isometric graft) and enhance surgical outcome [3, 18], using information collected pre-operatively via computed tomography (CT) or magnetic resonance imaging (MRI) scans. Indeed, CAS for orthopaedic purposes has entered the mainstream only in the last 10 years, providing, in addition to surgical guidance for reconstructive surgery based on anatomical features, a valuable feedback for kinematic analysis [5]. In fact, with the aid of imageless intra-operative registration, CAS systems are allowed to evaluate the passive range of motion and laxity associated with each specific reconstruction, both ligamentous and prosthetic ones. Besides achieving the correct anatomical features, a global and accurate functional evaluation should be recommended in order to reach the joint parameters as close as possible to its normal function.