MRI of double-bundle ACL reconstruction: evaluation of graft findings

• Published in: Skeletal radiology 2012-07, Vol.41 (7), p.835-842
• Main Authors: Kiekara, Tommi, Järvelä, Timo, Huhtala, Heini, Paakkala, Antti
• Format: Article
• Language: English
• Subjects: Adult; Anterior Cruciate Ligament - pathology; Anterior Cruciate Ligament - surgery; Anterior Cruciate Ligament - transplantation; Anterior Cruciate Ligament Reconstruction - methods; Female; Humans; Imaging; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Nuclear Medicine; Orthopedic surgery; Orthopedics; Pathology; Radiology; Reconstructive Surgical Procedures - methods; Reproducibility of Results; Scientific Article; Sensitivity and Specificity; Transplants; Treatment Outcome
• ISSN: 0364-2348; 1432-2161
• DOI: 10.1007/s00256-011-1285-1

Objective To demonstrate the magnetic resonance imaging (MRI) findings of double-bundle (DB) anterior cruciate ligament (ACL) reconstruction grafts. Materials and methods Sixty-six patients with DB ACL reconstruction were evaluated with MRI 2 years postoperatively. Graft thickness was measured separately by two musculoskeletal radiologists. The MRI findings of graft disruption, signal intensity (SI) changes, cystic degeneration, arthrofibrosis, and impingement were analyzed. The statistical significance of the association between MRI findings was calculated. Results The mean anteromedial (AM) graft thickness was reduced 9% and the mean posterolateral (PL) graft thickness was reduced 18% from the original graft thickness. Disruption was seen in 3% of AM grafts and 6% of PL grafts and a partial tear in 8 and 23%, respectively. Both grafts were disrupted in 3% of patients. Increased SI was seen in 14% of intact AM grafts and in 60% of partially torn AM grafts ( p  = 0.032). In PL grafts the increased SI was seen in 51% of the intact grafts and in 93% of the partially torn grafts ( p  = 0.005). Cystic degeneration was seen in 8% of AM grafts and in 5% of PL grafts. Diffuse arthrofibrosis was seen in 5% of patients and a localized cyclops lesion in 3% of patients. Impingement of the AM graft was seen in 8% of patients. Conclusion Both grafts were disrupted in 3% of patients. Also, the frequencies of other complications were low. The use of orthogonal sequences in the evaluation of the PL graft SI seems to cause volume-averaging artefacts.