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

作者：Tanaka Yoshinari^*; Yonetani Yasukazu; Shiozaki Yoshiki; Kanamoto Takashi; Kita Keisuke; Amano Hiroshi; Kusano Masashi; Hirakawa Masashi; Horibe Shuji

来源：Knee Surgery, Sports Traumatology, Arthroscopy, 2014, 22(7): 1541-1548.

DOI：10.1007/s00167-013-2557-1

• ACL graft
• Coronal oblique MRI
• Multiple bundle reconstruction
• Tendon-to-bone healing

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. %26lt;br%26gt;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. %26lt;br%26gt;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. %26lt;br%26gt;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. %26lt;br%26gt;III.

• 出版日期2014-7