Accuracy of Femoral Tunnel Localization With Mixed Reality Technology-Assisted Single-Bundle ACL Reconstruction.

Background: It is clinically challenging to accurately drill femoral and tibial tunnels to reconstruct the anterior cruciate ligament (ACL). Mixed reality (MR) technology, a further development of virtual reality technology, presents virtual scene information in real time and establishes an interactive feedback information loop among the real world, the virtual world, and the user. Purpose/Hypothesis: The purpose of this study was to investigate the structural and early clinical outcomes of ACL reconstruction assisted by MR technology. It was hypothesized that MR technology would improve the accuracy of tunnel localization. Study Design: Cohort study; Level of evidence, 3. Methods: Included were 44 patients at a single institution who underwent arthroscopic single-bundle ACL reconstruction between June 2020 and March 2022. Reconstruction with the aid of MR technology was performed in 21 patients (MR group), and conventional arthroscopic reconstruction was performed in 23 patients. Postoperatively, the parameters related to the bone tunnel positioning were compared by computed tomography imaging with 3-dimensional (3D) reconstruction, and 12-month postoperative clinical outcomes were assessed with the Lysholm and International Knee Documentation Committee scores. Results: There was no statistically significant difference in projection angles in the coronal, axial, or sagittal plane between the preoperative virtually created tunnel guide pin and the actual tunnel ( Conclusion: ACL reconstruction with the aid of MR technology allowed for more accurate positioning and orientation of the femoral tunnel during surgery when compared with conventional reconstruction.