Intelligent Planning Method for Femoral Tunnel Placement in Anterior Cruciate Ligament Reconstruction Surgery

To address the challenges in anterior cruciate ligament (ACL) reconstruction surgery—such as the high precision required for femoral tunnel positioning, lack of standardized procedures, and the time-consuming nature of preoperative planning—an intelligent femoral tunnel planning method based on CT imaging is proposed. This approach integrates techniques from 3D segmentation and reconstruction of knee joint CT images based on 3D U-Net and prior knowledge, with tunnel planning guided by the quadrant method and ratio analysis, aiming to improve the accuracy and standardization of both intra-articular and extra-articular femoral tunnel orifice localization. The proposed method was assessed through human-machine comparison and physical model validation. Experimental results demonstrate that the automated approach attains positioning accuracy comparable to that of expert manual operation, while offering faster speed and greater consistency.