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Effect of tunnel placements on clinical and magnetic resonance imaging findings 2 years after anterior cruciate ligament reconstruction using the double-bundle technique.

Suomalainen P, Kiekara T, Moisala AS, Paakkala A, Kannus P, Järvelä T - Open Access J Sports Med (2014)

Bottom Line: We found that the location of the graft in the tibia had an impact on the MRI visibility of the graft at 2-year follow-up.No association was found between the clinical results and the graft locations.Anterior graft location in the tibia can cause graft invisibility in the MRI 2 years after ACL reconstruction, but this has no effect on the clinical recovery of the patient.

View Article: PubMed Central - PubMed

Affiliation: Division of Orthopaedics and Traumatology, Department of Trauma, Musculoskeletal Surgery and Rehabilitation, Tampere University Hospital, Tampere, Finland.

ABSTRACT

Purpose: The purpose of the study reported here was to find out if the clinical and magnetic resonance imaging (MRI) findings of a reconstructed anterior cruciate ligament (ACL) have an association. Our hypothesis, which was based on the different functions of the ACL bundles, was that the visibility of the anteromedial graft would have an impact on anteroposterior stability, and the visibility of the posterolateral graft on rotational stability of the knee.

Methods: This study is a level II, prospective clinical and MRI study (NCT02000258). The study involved 75 patients. One experienced orthopedic surgeon performed all double-bundle ACL reconstructions. Two independent examiners made the clinical examinations at 2-year follow-up: clinical examination of the knee; KT-1000, International Knee Documentation Committee and Lysholm knee evaluation scores; and International Knee Documentation Committee functional score. The MRI evaluations were made by two musculoskeletal radiologists separately, and the means of these measurements were used.

Results: We found that the location of the graft in the tibia had an impact on the MRI visibility of the graft at 2-year follow-up. There were significantly more partially or totally invisible grafts if the insertion of the graft was more anterior in the tibia. No association was found between the clinical results and the graft locations.

Conclusion: Anterior graft location in the tibia can cause graft invisibility in the MRI 2 years after ACL reconstruction, but this has no effect on the clinical recovery of the patient.

No MeSH data available.


The maximum diameter of the tibia was measured from the sagittal images in millimeters (G) and the centers of the tunnels were determined from the anterior wall of the tibia (H, I).
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f2-oajsm-5-197: The maximum diameter of the tibia was measured from the sagittal images in millimeters (G) and the centers of the tunnels were determined from the anterior wall of the tibia (H, I).

Mentions: The measurements of the graft location from MRI were made using the method reported by Lorenz et al, although they used computed tomography in their study.20 The use of the modified quadrant method with MRI has been recently described in detail.21 In brief, first the centers of the tunnels were measured from sagittal images referring to Blumensaat’s line and to the posterior femoral condyle (Figure 1). These were then divided by the maximum diameters of the femoral condyle parallel to and perpendicular to Blumensaat’s line. On the tibial side, the centers of the tunnels were measured from the anterior edge of the tibial plateau and then divided by the maximum diameter of the plateau, which was measured from the sagittal view (Figure 2).


Effect of tunnel placements on clinical and magnetic resonance imaging findings 2 years after anterior cruciate ligament reconstruction using the double-bundle technique.

Suomalainen P, Kiekara T, Moisala AS, Paakkala A, Kannus P, Järvelä T - Open Access J Sports Med (2014)

The maximum diameter of the tibia was measured from the sagittal images in millimeters (G) and the centers of the tunnels were determined from the anterior wall of the tibia (H, I).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4155898&req=5

f2-oajsm-5-197: The maximum diameter of the tibia was measured from the sagittal images in millimeters (G) and the centers of the tunnels were determined from the anterior wall of the tibia (H, I).
Mentions: The measurements of the graft location from MRI were made using the method reported by Lorenz et al, although they used computed tomography in their study.20 The use of the modified quadrant method with MRI has been recently described in detail.21 In brief, first the centers of the tunnels were measured from sagittal images referring to Blumensaat’s line and to the posterior femoral condyle (Figure 1). These were then divided by the maximum diameters of the femoral condyle parallel to and perpendicular to Blumensaat’s line. On the tibial side, the centers of the tunnels were measured from the anterior edge of the tibial plateau and then divided by the maximum diameter of the plateau, which was measured from the sagittal view (Figure 2).

Bottom Line: We found that the location of the graft in the tibia had an impact on the MRI visibility of the graft at 2-year follow-up.No association was found between the clinical results and the graft locations.Anterior graft location in the tibia can cause graft invisibility in the MRI 2 years after ACL reconstruction, but this has no effect on the clinical recovery of the patient.

View Article: PubMed Central - PubMed

Affiliation: Division of Orthopaedics and Traumatology, Department of Trauma, Musculoskeletal Surgery and Rehabilitation, Tampere University Hospital, Tampere, Finland.

ABSTRACT

Purpose: The purpose of the study reported here was to find out if the clinical and magnetic resonance imaging (MRI) findings of a reconstructed anterior cruciate ligament (ACL) have an association. Our hypothesis, which was based on the different functions of the ACL bundles, was that the visibility of the anteromedial graft would have an impact on anteroposterior stability, and the visibility of the posterolateral graft on rotational stability of the knee.

Methods: This study is a level II, prospective clinical and MRI study (NCT02000258). The study involved 75 patients. One experienced orthopedic surgeon performed all double-bundle ACL reconstructions. Two independent examiners made the clinical examinations at 2-year follow-up: clinical examination of the knee; KT-1000, International Knee Documentation Committee and Lysholm knee evaluation scores; and International Knee Documentation Committee functional score. The MRI evaluations were made by two musculoskeletal radiologists separately, and the means of these measurements were used.

Results: We found that the location of the graft in the tibia had an impact on the MRI visibility of the graft at 2-year follow-up. There were significantly more partially or totally invisible grafts if the insertion of the graft was more anterior in the tibia. No association was found between the clinical results and the graft locations.

Conclusion: Anterior graft location in the tibia can cause graft invisibility in the MRI 2 years after ACL reconstruction, but this has no effect on the clinical recovery of the patient.

No MeSH data available.