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

Abstract

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.

Graft bending angle is correlated with femoral intraosseous graft signal intensity in anterior cruciate ligament reconstruction using the outside-in technique

“…In addition, high-signal-intensity lesions around the femoral tunnel aperture located posterosuperior to the graft, with an empty space between the graft and the tunnel aperture, were found in five cases. Some researchers have suggested that the high-signal-intensity lesions indicate poor graft-to-tunnel healing around the femoral tunnel aperture [21]. This study showed no significant statistical correlation between the high-signal-intensity lesion and the femoral tunnel bending angle.…”

“…The signal intensity of the ACL graft was measured using SNQ. The signal intensity was calculated at three zones of the intra-articular graft sites (tibial one-third, mid-substance, and femoral one-third), two intraosseous graft sites (tibial and femoral tunnel zone), and two other sites (posterior cruciate ligament and the background approximately one centimeter medial and two centimeters distal to the medial joint line) using a region of interest (ROI) with a 3.3-mm-diameter circle ( Figure 1) [21]. The signal intensity of the tibial tunnel zone was calculated at the lesion proximal to the tibial screw, to prevent its misinterpretation.…”

“…These intra-articular and intraosseous SNQ values for the ACL graft were measured on oblique coronal MRI images. In some cases, a highsignal-intensity lesion in the T2-weighted images between the graft and tunnel wall was reported [21]. Therefore, T2-weighted images were examined for the presence of high-signal-intensity lesions between the graft and the femoral and tibial tunnel apertures ( Figure 2).…”

Anterior knee symptoms after double-bundle ACL reconstruction with hamstring tendon autografts: an ultrasonographic and power Doppler investigation

“…Surgical procedure and post-operative rehabilitation Anatomic double-bundle ACL reconstruction with HT grafts was performed based on age and activity level as previously described [25]. Post-operatively, all patients underwent the same rehabilitation protocol.…”

Does fibrin clot really enhance graft healing after double-bundle ACL reconstruction in a caprine model?

“…Increased bone formation, decreased tunnel widening, increased collagen fibrils and increased load to failure have been described [7,19,33,36]. Recent research has focused on platelet-derived therapies [16,22,27,30,32].…”