Computed tomography (CT) scanners provide images of internal anatomy with unsurpassed spatial resolution. Since these images are inherently digital, computer systems can be used to simulate, plan, and guide surgical procedures to submillimeter precision. The combination of CT images, specially designed instruments, and the software to coordinate them results in improved accuracy for stereotactic surgery. This paper introduces per cutaneous cruciate ligament replacement as a new application for computer-aided ster eotaxi s. The procedure is described here with the knee firmly attached to a custom device. Twenty-five to thirty CT scans are performed to view the knee in detail, with special care taken to visualize the cruciate ligaments and their attachment to the tibia and femur. At the display console, two trajectories are chosen, using images delivered by the scanner and alternative views generated by software. These trajectories position two attachment shafts through skeletal structure in the knee to secure a replacement cruciate ligament. Interaction is illustrated that allows both the selection of the trajectories and the simulated surgery along their path. Anatomy intersected by the proposed trajectories can be reviewed in detail prior to actual surgery. Once reviewed, frame sittings are delivered by the computer system to drill the ligament attachment shafts. A replacement cruciate ligament can be passed through these two drill holes. Only an arthroscopic procedure is needed for later fixation of the ligament. In this manner, 4-6 hour open surgery of the knee is avoided and patient rehabilitation should be reduced from several months to 4-5 weeks. The frame, software, procedure, and computational aspects of the interaction are described. Test and patient results are given.