Inferior graft maturity in the PL bundle after autograft hamstring double-bundle ACL reconstruction
| Autor: | Hideaki Fukuda, Hiroki Sakai, Akihiro Tsuchiya, Shigehiro Asai, Izumi Kanisawa, Kenji Takahashi, Tatsuya Takahashi, Takahiro Ogura |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Knee Joint Anterior cruciate ligament Transplants Transplantation Autologous 03 medical and health sciences Young Adult 0302 clinical medicine Double bundle Medicine Humans Orthopedics and Sports Medicine Postoperative Period Prospective Studies Anterior Cruciate Ligament Prospective cohort study Autografts 030222 orthopedics medicine.diagnostic_test Anterior Cruciate Ligament Reconstruction business.industry Hamstring Tendons Magnetic resonance imaging 030229 sport sciences Magnetic Resonance Imaging Graft maturity medicine.anatomical_structure Bundle Orthopedic surgery Surgery Female business Nuclear medicine Hamstring |
| Zdroj: | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 27(2) |
| ISSN: | 1433-7347 |
| Popis: | The purpose of this study was to evaluate the signal/noise quotient (SNQ) for graft maturation and the serial changes observed in the magnetic resonance imaging (MRI) findings after double-bundle (DB) anterior cruciate ligament (ACL) reconstruction using a hamstring tendon autograft at a minimum of 5 years after surgery. Forty-five patients who underwent DB ACL reconstruction between 2007 and 2010 were included in this prospective study. All participants underwent postoperative MRI at 3 weeks and 3, 6, 9 and 12, 18, 24, 36, 48 and 50 months. The signal intensity (SI) characteristics of the reconstructed graft were evaluated on oblique axial proton density-weighted MR imaging (PDWI) perpendicular to the grafts. The signal/noise quotient (SNQ) was calculated to quantitatively determine the normalized SI. The SNQ of the AMB and PLB was evaluated separately. The mean SNQ of the AM bundle (AMB) continued to increase until 6 months after surgery (5.2 ± 1.2), and then gradually decreased and became well stabilized by 18 months (3.3 ± 0.5), after which it remained unchanged. On the other hand, the mean SNQ of the PL bundle (PLB) continued to increase until 9 months after surgery (6.2 ± 1.1), and then decreased incrementally and became well stabilized by 24 months (4.1 ± 0.5). The SI of PLB was significantly higher than that of AMB between 3 and 24 months (p = 0.04, 0.03, 0.01, 0.04, 0.02 and 0.03, respectively). These results indicate that at least 18 months is needed after ACL reconstruction to sufficiently restore the SI of the AMB, while at least 24 months are needed to for the PLB. The SI of the PLB was significantly higher than that of the AMB at 3–24 months after surgery, indicating that the PLB showed inferior graft maturity to the AMB until 24 months after surgery. For clinical relevance, the correct understanding of serial changes in graft maturation may potentially be used in decision-making regarding a return to sports. Prospective case series, Level IV. |
| Databáze: | OpenAIRE |
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