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- Title
MRI analysis of single-, double-, and triple-bundle anterior cruciate ligament grafts.
- Authors
Tanaka, Yoshinari; Yonetani, Yasukazu; Shiozaki, Yoshiki; Kanamoto, Takashi; Kita, Keisuke; Amano, Hiroshi; Kusano, Masashi; Hirakawa, Masashi; Horibe, Shuji
- Abstract
Purpose: The purpose of the study was to evaluate the entire course of ACL grafts on coronal oblique MR images, focusing on differences in graft morphology and graft-to-tunnel healing among single-bundle (SB), double-bundle (DB), and triple-bundle (TB) reconstructions. Methods: Eighty-three patients underwent anatomical ACL reconstruction using the semitendinosus tendon. SB reconstruction was performed on 20 patients, DB on 29 patients, and TB on 34 patients. The anteromedial-bundle (AMB) and posterolateral-bundle (PLB) images were extracted from coronal oblique images of grafts at 6 months to visualize their entire course. Signal intensity of grafts was measured independently in three regions: (1) intra-femoral tunnel region, (2) intra-articular region, and (3) intra-tibial tunnel region, followed by calculation of the signal-to-noise quotient (SNQ). To evaluate graft-to-tunnel healing, T2-weighted images were examined for the presence of a high signal-intensity lesion between the graft and bone tunnel around the tunnel aperture. Results: AMB images showed that SB graft was thick throughout the entire course, while DB graft was thinner than SB graft. TB graft showed a fan shape approaching the tibial tunnels. The SNQ in the femoral tunnel of SB graft was significantly lower than in the DB and TB grafts. High signal-intensity lesions were frequently observed around the femoral tunnel aperture in PLB images of DB and TB grafts compared to SB grafts. Conclusion: Gross morphology of TB grafts resembled that of the natural ACL. However, the graft-to-tunnel healing around the femoral tunnel seemed to be insufficient in PLB images of DB and TB compared to SB grafts. Level of evidence: III.
- Subjects
ANTERIOR cruciate ligament surgery; MAGNETIC resonance imaging; SIGNAL-to-noise ratio; TENDON surgery; TIBIA surgery
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2014, Vol 22, Issue 7, p1541
- ISSN
0942-2056
- Publication type
Article
- DOI
10.1007/s00167-013-2557-1