| Part I Evaluation of Correlation between MR Signal Intensity withinGrafts and Knee Function after Double-Bundle Anterior CruciateLigament ReconstructionPurpose: A study was performed to analysis magnetic resonance (MR) signalintensity within grafts and knee function after double-bundle anterior cruciate ligament(ACL) reconstruction, to compare the knee function between group of increased signal ingrafts and group of normal signal, to study he diagnostic value of MRI in double-bundleACL reconstruction follow-up and whether signal intensity were correlated to the jointfunction.Material and Methods: Patients who were admitted to our hospital and receiveddouble-bundle ACL reconstruction of single knee between2010-2012were included andunderwent clinical follow-up by physical examination and3.0-T MR imaging of the kneethat was treated1to1.5years after surgery. We used autologous semitendinous andsemimembranous muscle complex as grafts. Exclusion criteria: intra-articular graft showedunclear because of metal artifacts, accompanied by preoperative synovial hyperplasia andother ligament injury, injuries after reconstruction.38patients were included,34males and4females, mean age (30±7.0) years of age. The patients were grouped according to theMRI signal intensity of the grafts. There were21patients in group of normal signal,16ingroup of increased signal in grafts, increased signal in both anteromedial (AM) bundlegraft and posterolateral (PL) bundle graft were found in12cases,3cases with increasedsignal in AM bundle graft,1case with increased signal in PL bundle graft. The dataabout Signal Noise Ratio（SNR） of proximal, middle, and distal of the AM bundle graft and PL bundle graft were measured respectively. The follow-up for both groups includedclinical evaluation with knee scores by IKDC after MRI examining1to1.5years afteroperation. Double knee tension was measured by KT-2000measurements. IKDC score andknee tension were compared for both groups. The correlation between SNR and IKDCscore and knee tension were calculated.Results: There were no statistical significances between the AM bundle grafts and thePL bundle grafts in both groups (P>0.05)). There were statistical significances betweenIKDC scores and knee tension for both groups (P <0.05). We found no correlation betweenSNR and IKDC score and knee tension (P>0.05).Conclusion: SNR of the grafts was not correlated to IKDC scores and knee tension ofdouble-bundle anterior cruciate ligament reconstruction. Simple high signal may indicatepoor function of the knee but could not suggest knee tension. Part II Correlation between Magnetic Resonance Signal within Graftsand Bone Tunnel Enlargement after Double-Bundle Anterior CruciateLigament ReconstructionPurpose: A study was performed to analysis bone tunnel enlargement and whether theenlargement was correlated to the increases of magnetic resonance (MR) signal in grafts1-1.5year after double-bundle anterior cruciate ligament (ACL) reconstruction..Material and Methods: Patients who were admitted to our hospital and receiveddouble-bundle ACL reconstruction of single knee between2010-2012were included andunderwent clinical follow-up by physical examination and3.0-T MR imaging of the kneethat was treated surgically1to1.5years after surgery. Exclusion criteria: intra-articulargraft showed unclear because of metal artifacts, accompanied by preoperative synovialhyperplasia and other ligament injury, injuries after reconstruction. The patients were grouped according to the MRI signal intensity of the grafts. The SNR of anteriomedial(AM) bundle and posterolateral (PL) bundle (same as the first portion) were obtained. Thedegree of bone tunnel expansion was measured on thin cross-sectional computedtomography (CT) images1week and3months after operation, respectively. Thecorrelation between bone tunnel enlargement and graft signal noise ratio (SNR) wasassessed.Results: There were statistical differences between group of normal signal and groupof increased signal of AM femoral tunnel and PL femoral tunnel (P <0.05). No significantassociation was seen between bone tunnel expansion and SNR in group of normal signal（P>0.05）. In group of increased signal, the correlation coefficient of bony tunnelenlargement of PL tibial tunnel, AM femoral tunnel, PL femoral tunnel and SNR were0.68,0.66,0.63, respectively. AM tibial tunnel and PL tibial tunnel coalition one weekafter ACL reconstruction was found in ten patients, five in group of normal signal (24%),five in the other group (31%), and there was no statistically significance as compared (χ2=0.145, P=0.703). The value of bone tunnel coalition enlargement was4.74±1.57mm inthe normal group, as it was2.84±1.83mm in group of increased signal, there was nostatistically significance between both (P>0.05).Conclusion: The degree of earlier expansion of PL tibial tunnel, AM femoral tunneland PL femoral tunnel can indicate the increase of signal in grafts1-1.5year afterdouble-bundle anterior cruciate ligament reconstruction.A higher occurrence was foundin the coalition of tibial tunnel after double-bundle anterior cruciate ligamentreconstruction but it does not affect the signal of the graft.. |
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