Theme
eP1 ePosters 1
Title
The Development of an Educational Training Package incorporating the Anterolateral Ligament into Standard Knee Anatomy using Cadaveric Dissection and Digital Reconstruction
Background
Medical education and surgical approaches are constantly evolving to remain in touch with recent advances. Recently, the anterolateral ligament (A.L.L.) was “discovered” as a distinct ligamentous structure from the knee capsule. It was long suspected to have a significant function regarding the stability of the knee joint. Claes et al (2013) demonstrated that the ALL was anatomically significant and must be considered surgically. - The use of Medical Visualisation in Anatomy has resulted in the production of several novel projects. One of these, Buchanan et al (2014) concerned the production of a multimedia package, which was designed to aid patient understanding, and rehabilitation of non-contact ACL injuries. It was therefore hypothesised that a revised model of knee anatomy could be digitally created that included the recently defined ALL and could be used to demonstrate its significance to healthcare professionals.
- This project aimed to incorporate the A.L.L. into an educational training package utilising both cadaveric dissection and digital reconstruction.
Summary of Work
Detailed cadaveric dissection was carried out to identify the A.L.L on two different lower limb specimens.- This was captured using digital photography specifically with an SLR Camera Nikon D5300.
- Using this imagery, an accurate model of the A.L.L. was developed using Autodesk 3DS Max and the Human Zygote Model.
- Following the creation of the A.L.L. model, it was incorporated into a series of animations showing movement of the lower limb. The animations were created using the Autodesk 3DS Max program and demonstrated standard knee flexion, internal tibial rotation, ACL injury and ALL injury.
- The model was then incorporated into a 3D interactive application using the Unity game engine, bringing the A.L.L. and the anatomy of knee joint into the digital age.
Summary of Results
- The cadaveric dissection was successful in identifying the ALL and demonstrated it as a clear structure that influences the movement of the knee joint.
- The 3D interactive model of the lower limb allows the A.L.L. to be visualised and incorporated the ligament successfully into standard knee anatomy in a digital setting
- Four separate animations were created illustrating the ALL’s function naturally and post injury. This was done to demonstrate the effect that the ALL has on the lower limb and why it must be considered when planning surgical procedures in this area.
- The 3D interactive application has a high degree of interactivity with an inbuilt multiple-choice quiz allowing users to test their anatomical knowledge. There is also the option for users to view dissection images of the A.L.L. and enhance their knowledge on this new area of anatomy.
Conclusion
- This project has created a novel educational training package that allows the users to build on their existing knowledge of the knee by incorporating recent research.
- The project also confirmed recent findings regarding the anatomy of the ALL and its effect on internal tibial rotation/anterior tibial translation.
- Teaching of the lower limb would be enhanced by the use of interactive applications such as the one created in this project.
Take-home Messages
- This project incorporates recent research into a novel educational training package for healthcare professionals in the field of orthopaedics in particular those interested in the anatomy of the knee.
- It also demonstrates that the combination of cadaveric dissecton and digital reconstruction can be very successful as in this instance a novel educational training package was produced that could educate future healthcare professionals as to the correct spatial anatomy of the knee joint.
References
- Buchanan, G., Ma, M., & Rea, P. M. (2014). A multimedia package for patient understanding and rehabilitation of non-contact anterior cruciate ligament injuries, 2(3), 44–53. doi:10.11648/j.ijmi.20140203.11
- Claes, S., Vereecke, E., Maes, M., Victor, J., Verdonk, P., & Bellemans, J. (2013). Anatomy of the anterolateral ligament of the knee. Journal of Anatomy, 223(4), 321–8. doi:10.1111/joa.12087
- Spitzer V, Ackerman A, Scherzinger A, Whitlock D. 1996. The Visible Human Male: A Technical Report. Journal of American Medical Informatics Association 3:118-130.