Document Detail


Serial magnetic resonance imaging evaluation of the patellar tendon after posterior cruciate ligament reconstruction.
MedLine Citation:
PMID:  11774140     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Our purpose was to prospectively analyze serial changes in magnetic resonance imaging (MRI) signal of the bone-patellar tendon-bone autograft when used for posterior cruciate ligament (PCL) reconstruction and to retrospectively determine at mid-term follow-up the relationship between MRI graft appearance and clinical stability in patients who have undergone arthroscopic PCL reconstruction with a bone-patellar tendon-bone autograft. TYPE OF STUDY: One prospective serial blinded study and 1 retrospective blinded study. METHODS: The first part of the study focused on MRI scans obtained at 3, 6, 9, and 12 months postoperatively in a case series of 10 consecutive patients who underwent arthroscopically assisted PCL reconstruction (group A), and of 10 patients who underwent combined ACL-PCL arthroscopic reconstruction (group B). For the second part of the study, MRI scans were obtained in a retrospective series of 10 patients at mid-term follow-up after PCL arthroscopic reconstruction (group C). Signal intensity of 3 zones, corresponding to the proximal, middle, and distal intra-articular graft zones, was evaluated according to the Howell et al. classification. Fiber continuity assessment was performed using a modified Kühne et al. score. The signal intensity of the 3 zones was independently scored. Knee stability was clinically and instrumentally graded according to the IKDC evaluation form (group 4). A multivariance analysis and grouped t test were used for statistical evaluation. RESULTS: In group A, the average MRI evaluation score was 7.65 +/- 1.6 at 3 months, 3.8 +/- 0.6 at 6 months, 4.75 +/- 1 at 9 months and 6.25 +/- 1.2 at 1 year. The portion of graft exiting the femoral tunnel exhibited increased signal and faster maturation than the tibial tunnel. In group B (combined ACL-PCL reconstruction), the graft showed slower graft healing with an average MRI score of 4.85 +/- 0.7 at 3 months, 1.9 +/- 0.7 at 6 months, 3.9 +/- 0.9 at 9 months, and 5.3 +/- 1.1 at 1 year. At 1 year follow-up, there was no correlation between MRI appearance and stability in group A, even with MRI findings of fiber continuity. However, at long-term evaluation (group C), a strict correlation between MRI appearance and achieved stability was found. CONCLUSIONS: The patellar tendon when used for PCL reconstruction requires more than 1 year to achieve a low-signal intensity over its entire course, and the distal zone near the tibial tunnel shows a slower healing process. MRI graft assessment is useful only 1 year or more following PCL reconstruction.
Authors:
Pier Paolo Mariani; Fabrizio Margheritini; Gianluca Camillieri; Alberto Bellelli
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association     Volume:  18     ISSN:  1526-3231     ISO Abbreviation:  Arthroscopy     Publication Date:  2002 Jan 
Date Detail:
Created Date:  2002-01-04     Completed Date:  2002-03-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8506498     Medline TA:  Arthroscopy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  38-45     Citation Subset:  IM    
Affiliation:
Rome University of Motor Sciences, Department of Diagnostic Radiology, San Pietro Hospital FBF, Rome, Italy. ppm.las@iol.it
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Arthroscopy / methods*
Female
Follow-Up Studies
Humans
Knee Injuries / pathology*,  physiopathology,  surgery*
Magnetic Resonance Imaging*
Male
Posterior Cruciate Ligament / injuries,  pathology*,  physiopathology,  surgery*
Prospective Studies
Retrospective Studies
Tendons / transplantation*
Time Factors
Wound Healing

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


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