Surgical Simulation for Placement of Isometric Point of Anterior Cruciate Ligament: A System using Three-dimensional Computer Models and Rapid Prototyping Models

Abstract

Purpose : This research aims at developing a simulation system for training of the correct placement of isometric points in arthroscopic reconstruction of anterior cruciate ligaments, using personal computer-based software and rapid prototyping knee models. Materials and Methods : CT scan images of the knee joints of thirteen patients were used. Simulation software was developed on V-works (Clinic3D Inc.), a three-dimensional medical imaging system. Rapid prototyping models were made of hardened starch with a 0.178 mm slice thickness. Results : In the first phase, trainee surgeons can study the positions of the bony attachments of healthy anterior cruciate ligaments, and compare their multiplanar reformatting images and a three-dimensional computer model of the bones. In the second phase, trainee surgeons can place isometric points on the three-dimensional computer models and compare the results with the points set by a supervising surgeon. Finally, rapid prototyping models, which are almost identical to the actual bones, are produced to allow the trainees to observe the isometric points marked on the models. Conclusion : Our system can provide a patient-specific simulation environment for beginners at arthroscopic anterior cruciate ligament reconstruction. It can be used as an educational and training tool for locating the isometric point of the anterior cruciate ligament during an operation.

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