Surgical Navigation in Knee Ligament Reconstruction

The use of computer navigation in ACL reconstruction was first established in the mid-1990s. Initial applications of this new technology focused on improving the accuracy and repeatability of tunnel placement. More recent indications focus on intraoperative assessment of knee ligament dynamic laxity measurements. Computer navigation has been used increasingly as a quantitative measurement tool to assess ACL graft obliquity or visualization of the pivot-shift phenomenon. Applications for PCL and MCL reconstruction have not been extensively studied thus far, although specific isometric or laxity measurements could be performed. Future applications include noninvasive registration techniques to use navigation as a combined preoperative, intraoperative and postoperative measurement tool. The purpose of this review is to provide an overview of the current applications and limitations of navigation in knee ligament reconstruction by reviewing the currently available literature.