Challenge

The idea for ACL-X arose directly from the daily surgical routine of a cruciate ligament surgeon in the Sportsclinic Cologne in Germany. It seemed imprecise, time-consuming and outdated to perform the measurement of an intraoperative X-ray image during cruciate ligament surgery – if at all – with the help of manual ruler measurements on the X-ray image. The question was: would it be imaginable to support the surgeon during cruciate ligament surgery with the help of a smartphone app?

In order to avoid any user hurdles, the app had to be applicable as a separate tool that could be used quickly, – i.e. without a lengthy login and without complex integration into other systems. The approach was to simply “partially digitalize” the known process based on the X-ray image: A photo of the X-ray image had to be sufficient to virtually draw auxiliary lines on it in the app. On this basis, the actual drill channel position could be referenced and quantified according to a recognized, scientific calculation method.

Process

In a prototype, Linova, with the expert support of a cruciate ligament surgeon, first validated the basic feasibility of the core features: the use of a simple photo of an X-ray image as a basis and the overlaying of the image with virtual guidelines in order to calculate the optimal drill channel position according to the quadrant method by Bernard and Hertel.

A professional UI/UX design, security hints, continuous context help, in-app-purchases for calculation contingents, an archive as well as an export function gradually rounded off the app for productive use.

The smooth, agile implementation and integration of these features also highlighted the benefits of our development and collaboration processes and tools in the Sportsclinic Cologne, Linova and QuickBird Medical network.