Search Filters

  • Media Source
  • Presentation Format
  • Media Type
  • Media Year
  • Language
  • Diagnosis / Condition
  • Diagnosis Method
  • Patient Populations
  • Treatment / Technique

Postoperative MRI following QT- ACLR and its Relevance for Rehabilitation

Postoperative MRI following QT- ACLR and its Relevance for Rehabilitation

Magdalena Stawinska, MPT, POLAND Marcin Plenzler, MPT, POLAND Robert Smigielski, MD, PhD, POLAND Beata Ciszkowska-Lyson, PhD, POLAND

LifeInstitute, Warsaw, POLAND


2023 Congress   ePoster Presentation   2023 Congress   rating (1)

 

Anatomic Location

Anatomic Structure

Diagnosis / Condition

Treatment / Technique

Ligaments

ACL

Diagnosis Method

MRI


Summary: Evaluation of the MRI signal of quadriceps tendon graft as autograft maturation process during the first 18 months following ACLR


Background

The appearance of the anterior cruciate ligament (ACL) on magnetic resonance imaging (MRI) is correlated to structural postoperative changes, graft maturity and knee stability after ACL reconstruction (ACLR). The purpose of this study was to evaluate the MRI signal of quadriceps tendon graft as autograft maturation process during the first 18 months following ACLR and compare it to a native ACL signal intensity (SI).

Methods

A total of 38 patients (23 males and 15 females,) who underwent reconstruction with an autologous tendon graft, were reviewed in MRI scan 3, 6, 9, 12 and 18 months after ACLR. A control group included 84 healthy adults with intact ACL (35 males and 49 females). 3-T MRI was used. Measurement of signal intensity was performed on PDWI sagittal plane. SI was measured manually in four regions of interest (ROI): proximal, middle, and distal intra-articular portions of the graft and PCL. An ACL/PCL ratio, named APR, was calculated and compared over time (3 to 18 months) and to intact ACL signal intensity.

Results

Mean signal intensity (MSI) has changed significantly in the proximal (p<0,001),mid-substance (p<0,001) and distal (p<0,001) portion of ACL graft over months, but the change was nonlinear. The most hyper-intense period was in 6 months for all the portions of the graft (p<0,01). The APR of the distal section was significantly higher in all periods compared to proximal and mid-substance except from 6 months postoperatively where the proximal part achieved the highest value (p<0,01). After 18 months after ACLR (not every study participant has completed full MRI procedure) the SI did not reach the levels of MSI-native ACL. The quadriceps graft had approximately 85% MRI -SI compared with native ACL.

Conclusion

The period between 3 to 6 month seems to be crucial for graft maturation process. Higher hyper-intensity indicates that graft undergoes intensive remodelling process, which seems to slow down after 6 months but still continues. The remodelling of the graft is an ongoing process even 18 months after surgery. MRI Imaging may be a useful clinical measure monitoring graft remodelling process after ACLR. Better knowledge of maturation changes observed over time, related to signal intensity-SI in MRI, should be a helpful tool to implement progression or regression in a selection of activities (especially regarding a decision of returning to sport), not only for orthopaedists but also for physiotherapists.


More 2023 ISAKOS Congress Content