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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 3/2015

01.03.2015 | Knee

Graft maturity of the reconstructed anterior cruciate ligament 6 months postoperatively: a magnetic resonance imaging evaluation of quadriceps tendon with bone block and hamstring tendon autografts

verfasst von: Yong Ma, Christopher D. Murawski, Amir Ata Rahnemai-Azar, Catherine Maldjian, Andrew D. Lynch, Freddie H. Fu

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 3/2015

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Abstract

Purpose

The purpose of this study was to report the potential differences associated with graft maturity measured on magnetic resonance imaging (MRI) between quadriceps tendon with bone block and hamstring tendon autografts 6 months after ACL reconstruction.

Methods

Twenty-six patients (15 male, 11 female; mean age 29.4 ± 17 years, range 13–46 years) who had undergone anatomic SB ACL reconstruction with either hamstring or quadriceps tendon with bone block autografts and had postoperative MRI 6 months after surgery. In 12 cases, the quadriceps tendon with bone block was used and hamstring in 14 cases. The signal/noise quotient was calculated to compare the difference between quadriceps tendon with bone block and hamstring autografts.

Results

Mean signal/noise quotient is lesser in quadriceps tendon with bone block (1.74 ± 0.39) compared with HS (2.44 ± 0.61) autografts (p = 0.020). For hamstring autograft, the distal region showed a significantly lower mean signal/noise quotient value compared with middle region, and the mean signal/noise quotient value in proximal region was the highest (distal vs middle p < 0.001; middle vs proximal p = 0.007; proximal vs distal p < 0.001). The mean signal/noise quotient of proximal region in quadriceps tendon with bone block autograft was lesser than that in hamstring. The middle region of the quadriceps tendon with bone block graft demonstrated the greatest signal/noise quotient [distal vs middle p = 0.001; middle vs proximal p = 0.027; proximal vs distal (n.s.)].

Conclusion

The maturity of quadriceps tendon with bone block was better in comparison with hamstring 6 months after anatomic SB ACL reconstruction. This study is clinically relevant in that modifying the individual rehabilitation according to the extent of graft maturity may be necessary to optimize patient function and prevent re-injury of the ACL graft.

Level of evidence

Retrospective case series, Level IV.
Literatur
1.
Zurück zum Zitat Amiel D, Akeson WH, Renzoni S, Harwood F, Abel M (1986) Nutrition of cruciate ligament reconstruction by diffusion: collagen synthesis studied in rabbits. Acta Orthop Scand 57:201–203CrossRefPubMed Amiel D, Akeson WH, Renzoni S, Harwood F, Abel M (1986) Nutrition of cruciate ligament reconstruction by diffusion: collagen synthesis studied in rabbits. Acta Orthop Scand 57:201–203CrossRefPubMed
2.
Zurück zum Zitat Amiel D, Kleiner JB, Roux RD, Harwood FL, Akeson WH (1986) The phenomenon of “ligamentization”: anterior cruciate ligament reconstruction with autogenous patellar tendon. J Orthop Res 4:162–172CrossRefPubMed Amiel D, Kleiner JB, Roux RD, Harwood FL, Akeson WH (1986) The phenomenon of “ligamentization”: anterior cruciate ligament reconstruction with autogenous patellar tendon. J Orthop Res 4:162–172CrossRefPubMed
3.
Zurück zum Zitat Arai Y, Hara K, Takahashi T, Urade H, Minami G, Takamiya H, Kubo T (2008) Evaluation of the vascular status of autogenous hamstring tendon grafts after anterior cruciate ligament reconstruction in humans using magnetic resonance angiography. Knee Surg Sports Traumatol Arthrosc 16:342–347CrossRefPubMed Arai Y, Hara K, Takahashi T, Urade H, Minami G, Takamiya H, Kubo T (2008) Evaluation of the vascular status of autogenous hamstring tendon grafts after anterior cruciate ligament reconstruction in humans using magnetic resonance angiography. Knee Surg Sports Traumatol Arthrosc 16:342–347CrossRefPubMed
4.
Zurück zum Zitat Araujo PH, van Eck CF, Macalena JA, Fu FH (2011) Advances in the three-portal technique for anatomical single- or double-bundle ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 19:1239–1242CrossRefPubMedCentralPubMed Araujo PH, van Eck CF, Macalena JA, Fu FH (2011) Advances in the three-portal technique for anatomical single- or double-bundle ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 19:1239–1242CrossRefPubMedCentralPubMed
5.
Zurück zum Zitat Arnoczky SP, Tarvin GB, Marshall JL (1982) Anterior cruciate ligament replacement using patellar tendon: an evaluation of graft revascularization in the dog. J Bone Joint Surg Am 64:217–224PubMed Arnoczky SP, Tarvin GB, Marshall JL (1982) Anterior cruciate ligament replacement using patellar tendon: an evaluation of graft revascularization in the dog. J Bone Joint Surg Am 64:217–224PubMed
6.
Zurück zum Zitat Claes S, Verdonk P, Forsyth R, Bellemans J (2011) The “ligamentization” process in anterior cruciate ligament reconstruction: what happens to the human graft? A systematic review of the literature. Am J Sports Med 39:2476–2483CrossRefPubMed Claes S, Verdonk P, Forsyth R, Bellemans J (2011) The “ligamentization” process in anterior cruciate ligament reconstruction: what happens to the human graft? A systematic review of the literature. Am J Sports Med 39:2476–2483CrossRefPubMed
7.
Zurück zum Zitat Clancy WG Jr, Narechania RG, Rosenberg TD, Gmeiner JG, Wisnefske DD, Lange TA (1981) Anterior and posterior cruciate ligament reconstruction in rhesus monkeys: a histological, microangiographic, and biomechanical analysis. J Bone Joint Surg Am 63:1270–1284PubMed Clancy WG Jr, Narechania RG, Rosenberg TD, Gmeiner JG, Wisnefske DD, Lange TA (1981) Anterior and posterior cruciate ligament reconstruction in rhesus monkeys: a histological, microangiographic, and biomechanical analysis. J Bone Joint Surg Am 63:1270–1284PubMed
8.
Zurück zum Zitat Espregueira-Mendes J, Lopes JM, Castro C, Oliveira J (1998) Time of remodelling of the patella tendon graft in anterior cruciate ligament surgery: a histological and immunohistochemical study in a rabbit model. Knee 5:9–19CrossRef Espregueira-Mendes J, Lopes JM, Castro C, Oliveira J (1998) Time of remodelling of the patella tendon graft in anterior cruciate ligament surgery: a histological and immunohistochemical study in a rabbit model. Knee 5:9–19CrossRef
9.
Zurück zum Zitat Falconiero RP, DiStefano VJ, Cook TM (1998) Revascularization and ligamentization of autogenous anterior cruciate ligament grafts in humans. Arthrosc 14:197–205CrossRef Falconiero RP, DiStefano VJ, Cook TM (1998) Revascularization and ligamentization of autogenous anterior cruciate ligament grafts in humans. Arthrosc 14:197–205CrossRef
10.
Zurück zum Zitat Harris JD, Erickson BJ, Bach BR Jr, Abrams GD, Cvetanovich GL, Forsythe B, McCormick FM, Gupta AK, Cole BJ (2013) Return-to-sport and performance after anterior cruciate ligament reconstruction in National Basketball Association Players. Sports Health 5:562–568CrossRefPubMedCentralPubMed Harris JD, Erickson BJ, Bach BR Jr, Abrams GD, Cvetanovich GL, Forsythe B, McCormick FM, Gupta AK, Cole BJ (2013) Return-to-sport and performance after anterior cruciate ligament reconstruction in National Basketball Association Players. Sports Health 5:562–568CrossRefPubMedCentralPubMed
11.
Zurück zum Zitat Hofbauer M, Muller B, Murawski CD, van Eck CF, Fu FH (2014) The concept of individualized anatomic anterior cruciate ligament (ACL) reconstruction. Knee Surg Sports Traumatol Arthrosc 22:979–986PubMed Hofbauer M, Muller B, Murawski CD, van Eck CF, Fu FH (2014) The concept of individualized anatomic anterior cruciate ligament (ACL) reconstruction. Knee Surg Sports Traumatol Arthrosc 22:979–986PubMed
12.
Zurück zum Zitat Janssen RP, Scheffler SU (2013) Intra-articular remodelling of hamstring tendon grafts after nterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 22:2102–2108CrossRefPubMedCentralPubMed Janssen RP, Scheffler SU (2013) Intra-articular remodelling of hamstring tendon grafts after nterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 22:2102–2108CrossRefPubMedCentralPubMed
15.
Zurück zum Zitat Mellado JM, Calmet J, Olona M, Giné J, Saurí A (2004) Magnetic resonance imaging of anterior cruciate ligament tears: reevaluation of quantitative parameters and imaging findings including a simplified method for measuring the anterior cruciate ligament angle. Knee Surg Sports Traumatol Arthrosc 12:217–224CrossRefPubMed Mellado JM, Calmet J, Olona M, Giné J, Saurí A (2004) Magnetic resonance imaging of anterior cruciate ligament tears: reevaluation of quantitative parameters and imaging findings including a simplified method for measuring the anterior cruciate ligament angle. Knee Surg Sports Traumatol Arthrosc 12:217–224CrossRefPubMed
16.
Zurück zum Zitat Muller B, Bowman KF Jr, Bedi A (2013) ACL graft healing and biologics. Clin Sports Med 32:93–109CrossRefPubMed Muller B, Bowman KF Jr, Bedi A (2013) ACL graft healing and biologics. Clin Sports Med 32:93–109CrossRefPubMed
17.
Zurück zum Zitat Muramatsu K, Hachiya Y, Izawa H (2008) Serial evaluation of human anterior cruciate ligament grafts by contrast-enhanced magnetic resonance imaging: comparison of allografts and autografts. Arthrosco 24:1038–1044CrossRef Muramatsu K, Hachiya Y, Izawa H (2008) Serial evaluation of human anterior cruciate ligament grafts by contrast-enhanced magnetic resonance imaging: comparison of allografts and autografts. Arthrosco 24:1038–1044CrossRef
18.
Zurück zum Zitat Ntoulia A, Papadopoulou F, Ristanis S, Argyropoulou M, Georgoulis AD (2011) Revascularization process of the bone–patellar tendon–bone autograft evaluated by contrast-enhanced magnetic resonance imaging 6 and 12 months after anterior cruciate ligament reconstruction. Am J Sports Med 39:1478–1486CrossRefPubMed Ntoulia A, Papadopoulou F, Ristanis S, Argyropoulou M, Georgoulis AD (2011) Revascularization process of the bone–patellar tendon–bone autograft evaluated by contrast-enhanced magnetic resonance imaging 6 and 12 months after anterior cruciate ligament reconstruction. Am J Sports Med 39:1478–1486CrossRefPubMed
19.
Zurück zum Zitat Papageorgiou CD, Ma CB, Abramowitch SD, Clineff TD, Woo SL (2011) A multidisciplinary study of the healing of an intraarticular anterior cruciate ligament graft in a goat model. Am J Sports Med 29:620–626 Papageorgiou CD, Ma CB, Abramowitch SD, Clineff TD, Woo SL (2011) A multidisciplinary study of the healing of an intraarticular anterior cruciate ligament graft in a goat model. Am J Sports Med 29:620–626
20.
Zurück zum Zitat Persson A, Fjeldsgaard K, Gjertsen JE, Kjellsen AB, Engebretsen L, Hole RM, Fevang JM (2014) Increased risk of revision with hamstring tendon grafts compared with patellar tendon grafts after anterior cruciate ligament reconstruction: a study of 12,643 patients from the norwegian cruciate ligament registry, 2004–2012. Am J Sports Med 42:285–291CrossRefPubMed Persson A, Fjeldsgaard K, Gjertsen JE, Kjellsen AB, Engebretsen L, Hole RM, Fevang JM (2014) Increased risk of revision with hamstring tendon grafts compared with patellar tendon grafts after anterior cruciate ligament reconstruction: a study of 12,643 patients from the norwegian cruciate ligament registry, 2004–2012. Am J Sports Med 42:285–291CrossRefPubMed
21.
Zurück zum Zitat Saddik D, McNally EG, Richardson M (2004) MRI of Hoffa’s fat pad. Skelet Radiol 33:433–444CrossRef Saddik D, McNally EG, Richardson M (2004) MRI of Hoffa’s fat pad. Skelet Radiol 33:433–444CrossRef
22.
Zurück zum Zitat Scheffler SU, Unterhauser FN, Weiler A (2008) Graft remodeling and ligamentization after cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 16:834–842CrossRefPubMed Scheffler SU, Unterhauser FN, Weiler A (2008) Graft remodeling and ligamentization after cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 16:834–842CrossRefPubMed
23.
Zurück zum Zitat Schulz AP, Lange V, Gille J, Voigt C, Fröhlich S, Stuhr M, Jürgens C (2013) Anterior cruciate ligament reconstruction using bone plug-free quadriceps tendon autograft: intermediate-term clinical outcome after 24–36 months. Open Access J Sports Med 19:243–249CrossRef Schulz AP, Lange V, Gille J, Voigt C, Fröhlich S, Stuhr M, Jürgens C (2013) Anterior cruciate ligament reconstruction using bone plug-free quadriceps tendon autograft: intermediate-term clinical outcome after 24–36 months. Open Access J Sports Med 19:243–249CrossRef
24.
Zurück zum Zitat Smith MA, Smith WT, Kosko P (2014) Anterior cruciate ligament tears: reconstruction and rehabilitation. Orthop Nurs 33:14–24CrossRefPubMed Smith MA, Smith WT, Kosko P (2014) Anterior cruciate ligament tears: reconstruction and rehabilitation. Orthop Nurs 33:14–24CrossRefPubMed
25.
Zurück zum Zitat Staeubli HU, Adam O, Becker W, Burgkart R (1999) Anterior cruciate ligament and intercondylar notch in the coronal oblique plane: anatomy complemented by magnetic resonance imaging in cruciate ligament-intact knees. Arthroscopy 15:349–359CrossRefPubMed Staeubli HU, Adam O, Becker W, Burgkart R (1999) Anterior cruciate ligament and intercondylar notch in the coronal oblique plane: anatomy complemented by magnetic resonance imaging in cruciate ligament-intact knees. Arthroscopy 15:349–359CrossRefPubMed
26.
Zurück zum Zitat Stener S, Ejerhed L, Movin T, Sernert N, Papadogiannakis N, Kartus J (2012) The reharvested patellar tendon has the potential for ligamentization when used for anterior cruciate ligament revision surgery. Knee Surg Sports Traumatol Arthrosc 20:1168–1174CrossRefPubMed Stener S, Ejerhed L, Movin T, Sernert N, Papadogiannakis N, Kartus J (2012) The reharvested patellar tendon has the potential for ligamentization when used for anterior cruciate ligament revision surgery. Knee Surg Sports Traumatol Arthrosc 20:1168–1174CrossRefPubMed
27.
Zurück zum Zitat Tanaka Y, Shiozaki Y, Yonetani Y, Kanamoto T, Tsujii A, Horibe S (2011) MRI analysis of the attachment of the anteromedial and posterolateral bundles of anterior cruciate ligament using coronal oblique images. Knee Surg Sports Traumatol Arthrosc 19(Suppl 1):S54–S59CrossRefPubMed Tanaka Y, Shiozaki Y, Yonetani Y, Kanamoto T, Tsujii A, Horibe S (2011) MRI analysis of the attachment of the anteromedial and posterolateral bundles of anterior cruciate ligament using coronal oblique images. Knee Surg Sports Traumatol Arthrosc 19(Suppl 1):S54–S59CrossRefPubMed
28.
Zurück zum Zitat Tanaka Y, Yonetani Y, Shiozaki Y, Kanamoto T, Kita K, Amano H, Kusano M, Hirakawa M, Horibe S (2014) MRI analysis of single-, double-, and triple-bundle anterior cruciate ligament grafts. Knee Surg Sports Traumatol Arthrosc 22:1541–1548CrossRefPubMed Tanaka Y, Yonetani Y, Shiozaki Y, Kanamoto T, Kita K, Amano H, Kusano M, Hirakawa M, Horibe S (2014) MRI analysis of single-, double-, and triple-bundle anterior cruciate ligament grafts. Knee Surg Sports Traumatol Arthrosc 22:1541–1548CrossRefPubMed
29.
Zurück zum Zitat Unterhauser FN, Bail HJ, Höher J, Haas NP, Weiler A (2003) Endoligamentous revascularization of an anterior cruciate ligament graft. Clin Orthop Relat Res Sep 414:276–288CrossRef Unterhauser FN, Bail HJ, Höher J, Haas NP, Weiler A (2003) Endoligamentous revascularization of an anterior cruciate ligament graft. Clin Orthop Relat Res Sep 414:276–288CrossRef
30.
Zurück zum Zitat Weiler A, Peters G, Mäurer J, Unterhauser FN, Südkamp NP (2001) Biomechanical properties and vascularity of an anterior cruciate ligament graft can be predicted by contrast-enhanced magnetic resonance imaging. A two-year study in sheep. Am J Sports Med 29:751–761PubMed Weiler A, Peters G, Mäurer J, Unterhauser FN, Südkamp NP (2001) Biomechanical properties and vascularity of an anterior cruciate ligament graft can be predicted by contrast-enhanced magnetic resonance imaging. A two-year study in sheep. Am J Sports Med 29:751–761PubMed
Metadaten
Titel
Graft maturity of the reconstructed anterior cruciate ligament 6 months postoperatively: a magnetic resonance imaging evaluation of quadriceps tendon with bone block and hamstring tendon autografts
verfasst von
Yong Ma
Christopher D. Murawski
Amir Ata Rahnemai-Azar
Catherine Maldjian
Andrew D. Lynch
Freddie H. Fu
Publikationsdatum
01.03.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 3/2015
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-014-3302-0

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