Document Detail


Anterior cruciate ligament reconstruction by using bioabsorbable femoral cross pins: MR imaging findings at follow-up and comparison with clinical findings.
MedLine Citation:
PMID:  20308449     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine the frequency of imaging findings and complications related to bioabsorbable femoral cross pins at follow-up magnetic resonance (MR) imaging studies after anterior cruciate ligament (ACL) reconstruction and compare these MR imaging findings with clinical evaluation findings. MATERIALS AND METHODS: The institutional review board approved this retrospective study, and informed consent was waived. Follow-up MR imaging studies (average, 26 months after surgery) in 218 patients with prior ACL reconstruction were retrospectively reviewed. Cross-pin fracture, posterior transcortical breach, migration, resorption, and lateral prominence of cross pins, as well as the cross-pin angle relative to the transepicondylar line, were investigated on MR images. The clinical evaluation included Lachman, anterior drawer, and pivot shift tests, as well as assessment for joint tenderness. RESULTS: Fracture, posterior transcortical breach, migration, and lateral prominence of cross pins were excluded from analysis when at least one cross pin was completely resorbed (n = 16 patients). Forty-five fractured cross pins were seen in 35 (17%) of 202 patients. The posterior femoral cortex was breached in 57 (28%) of 202 patients. Migration of fractured pin fragments occurred in 12 (6%) of 202 patients. There was a significant relationship between fractures and posterior breach of cross pins (P = .001), as well as between cross-pin angles and fractures (P = .002). Both cross pins were completely resorbed in 12 (6%) of 218 patients (average time since surgery, 53 months; range, 8-92 months). No significant association was found between any MR imaging finding related to cross pins and clinical test findings. CONCLUSION: Fracture and posterior transcortical breach of bioabsorbable femoral cross pins, commonly seen at follow-up MR imaging studies, do not correlate with clinical findings of joint instability or pain. Posteriorly angulated cross pins and posterior transcortical breach are significantly associated with cross-pin fractures.
Authors:
Ueli Studler; Lawrence M White; Ali M Naraghi; George Tomlinson; Monica Kunz; Gadi Kahn; Paul Marks
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Radiology     Volume:  255     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-23     Completed Date:  2010-05-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  108-16     Citation Subset:  AIM; IM    
Copyright Information:
RSNA, 2010
Affiliation:
Department of Medical Imaging, Mount Sinai Hospital and University Health Network, University of Toronto, Toronto, Ontario, Canada. studleru@uhbs.ch
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MeSH Terms
Descriptor/Qualifier:
Absorbable Implants
Adolescent
Adult
Anterior Cruciate Ligament / injuries,  surgery*
Bone Nails*
Chi-Square Distribution
Female
Femur / surgery
Foreign-Body Migration / diagnosis
Humans
Joint Instability / diagnosis
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Pain Measurement
Postoperative Complications / diagnosis*
Prosthesis Failure
Retrospective Studies
Risk Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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