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Published in: Knee Surgery, Sports Traumatology, Arthroscopy 7/2014

01-07-2014 | Knee

MRI analysis of single-, double-, and triple-bundle anterior cruciate ligament grafts

Authors: Yoshinari Tanaka, Yasukazu Yonetani, Yoshiki Shiozaki, Takashi Kanamoto, Keisuke Kita, Hiroshi Amano, Masashi Kusano, Masashi Hirakawa, Shuji Horibe

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 7/2014

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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.
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Metadata
Title
MRI analysis of single-, double-, and triple-bundle anterior cruciate ligament grafts
Authors
Yoshinari Tanaka
Yasukazu Yonetani
Yoshiki Shiozaki
Takashi Kanamoto
Keisuke Kita
Hiroshi Amano
Masashi Kusano
Masashi Hirakawa
Shuji Horibe
Publication date
01-07-2014
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 7/2014
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-013-2557-1

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