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Chapter 9184artificial intelligence and machine learning. The same could be true for segmentation of the femur. When the 3D model of the femur increases in accuracy, the guide will likely increase in accuracy too.The technique we used to develop the patient-specific guide is not unique but had never been applied in ACL reconstruction surgery. The Boolean subtraction method has been used in several fields of medicine, including orthopaedics – for example when planning patient-specific guides for osteotomies, in both orthopaedic and maxillary procedures. 3D laboratories are quickly emerging throughout the Netherlands, in academic as well as large teaching hospitals. This may boost the use of patient-specific guides in orthopaedic procedures, including ACL reconstruction. This demands a sound scientific foundation to justify the all-round use of these guides. We have now developed an arthroscopic instrument that can be used in arthroscopic ACL reconstructions. To increase its accuracy, this instrument is made of stainless steel. Arthroscopic ACL reconstructions have been performed on four human cadavers, where we showed that the accuracy of the device has improved to 2 mm. This is sufficient for purposes of a pilot study we started aiming to assess the in vivo accuracy of this patient specific-surgical guide for the creation of a femoral tunnel in ACL reconstruction.Step by step, we aim to achieve a more individualised ACL reconstruction technique.Individualising rehabilitation after ACL reconstructionRehabilitation after ACL reconstruction is a continuum towards return to sports, where periodisation, neuromuscular training and psychological support are essential.8 The care for ACL-injured subjects needs to be individualised in order to improve return-to-sport rates.15 This thesis has explored new possibilities that can be used to offer a more individualised approach to ACL reconstruction and rehabilitation.Something that may appeal to many athletes is that with the KROS protocol the main focus lies on the outcome of the movement instead Mark Zee.indd 184 03-01-2024 08:56