Use of CT in the management of anterior cruciate ligament revision surgery

Groves, Clare; Chandramohan, M.; Chew, C. K.; Subedi, N.

doi:10.1016/j.crad.2013.06.001

Cited by 30 publications

(20 citation statements)

References 39 publications

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“…45,46 The current gold standard for evaluating tunnel widening is CT because studies have shown that CT outperforms MRI and radiographs in both inter-and intraobserver reliability for evaluating tunnel widening. [47][48][49] The authors favor a selective approach to ordering CT scans to evaluate tunnel position and widening. The decision to order a CT scan in addition to the radiographs and MRI is based on the quality of the MRI and the surgeon's comfort with using MRI to evaluate tunnel position and widening.…”

Section: Imaging Studiesmentioning

confidence: 99%

Two-Stage Revision Anterior Cruciate Ligament Reconstruction

Erickson¹,

Cvetanovich²,

Waliullah³

et al. 2016

Orthopedics

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The number of primary anterior cruciate ligament (ACL) tears is rapidly increasing. In patients who wish to return to their preoperative level of function, specifically as it pertains to participation in sports, the gold standard of treatment following an ACL tear remains an anterior cruciate ligament (ACL) reconstruction. Despite a majority of good/excellent results following primary ACL reconstruction, there is a growing subset of patients with persistent or recurrent functional instability who require revision ACL reconstruction. Preoperative planning for revision ACL reconstruction requires a careful understanding of the root cause of ACL failure, including possible technical causes of primary ACL failure and the presence of combined knee pathology that was not addressed at the index ACL reconstruction. The decision to perform 2-stage revision ACL reconstruction is multifactorial and is reached by technical considerations that may make a 1-stage revision less optimal, including tunnel widening, arthrofibrosis, active infection, and others. Concomitant knee pathology such as meniscal deficiency, malalignment (including an increase in posterior tibial slope), chondral lesions, and other ligamentous laxity may also require a staged approach to treatment. This evidence-based review covers the indications for 2-stage revision ACL reconstruction, surgical techniques, evidence for and technique of bone grafting prior ACL tunnels, and outcomes of 2-stage revision stratified by initial cause of ACL reconstruction failure. With proper preoperative planning and an understanding of the cause of failure following the primary ACL reconstruction, revision ACL reconstruction can offer excellent outcomes in the motivated patient. [Orthopedics. 2016; 39(3):e456-e464.].

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Section: Imaging Studiesmentioning

confidence: 99%

Two-Stage Revision Anterior Cruciate Ligament Reconstruction

Erickson¹,

Cvetanovich²,

Waliullah³

et al. 2016

Orthopedics

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“…8,11 CT scan is the best modality for evaluating bone tunnel widening and the first choice modality in the management of ACL revision surgery to assess bone stock quality and bone graft incorporation. 20,25 The radiolucency around the graft associated with tunnel widening is the apparent result of bone resorption in the insertion site area. 25,26 This finding is supported by MRI data, showing fluid signal, rather than bone signal, surrounding the tendon.…”

Section: Imaging Techniques Plain Radiography and Volumetric Ct Scanmentioning

confidence: 99%

“…20,25 The radiolucency around the graft associated with tunnel widening is the apparent result of bone resorption in the insertion site area. 25,26 This finding is supported by MRI data, showing fluid signal, rather than bone signal, surrounding the tendon. The presence of bone resorption at the graft insertion site as early as 3 months after ACL reconstruction needs to be followed closely.…”

Section: Imaging Techniques Plain Radiography and Volumetric Ct Scanmentioning

confidence: 99%

Imaging of the Postoperative Anterior Cruciate Ligament: Emphasis on New Surgical and Imaging Methods

Dyck

Lambrecht

Smet

et al. 2016

Semin Musculoskelet Radiol

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The aim of anterior cruciate ligament (ACL) reconstruction is to restore normal function of the knee, but unfortunately abnormal kinematics and a predisposition to knee osteoarthritis occur in a significant percentage of patients. So there is an ongoing need to improve treatment options and long-term outcome of patients with a ruptured ACL. With the recent advancements in the field of ACL tissue engineering, the focus of treatment for ACL injuries is changing from resection and reconstruction toward repair and regeneration. Several new ACL repair methods were recently introduced as an alternative to traditional ACL reconstructive procedures. Radiologists must become familiar with these new surgical methods to interpret their appearance correctly on postoperative imaging studies. This article provides an overview of the latest advancements in ACL surgical methods and discusses the role of imaging to assess the postoperative ACL including both standard and advanced imaging methods.

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“…Eleven review articles were identified from the past 10 years on the topic of revision ACL surgery and related subjects. Five reviews focused on risks and causes of primary ACL reconstruction failure,8 10–13 four on indications/strategies and techniques of revision surgeries,8 10 14 15 and four on clinical outcomes;16–19 two of them focused on return to sports 17 18. In addition, one recent article described strategies for revision surgery after primary double-bundle (DB) ACL reconstruction 20.…”

Section: Introductionmentioning

confidence: 99%