ACL hamstring grafts fixed using adjustable cortical suspension in both the femur and tibia demonstrate healing and integration on MRI at one year.
Knee Surg Sports Traumatol Arthrosc
; 28(3): 906-914, 2020 Mar.
Article
em En
| MEDLINE
| ID: mdl-31209542
ABSTRACT
PURPOSE:
To present the clinical outcomes and magnetic resonance imaging (MRI) analysis of adjustable cortical suspensory fixation for the femur and tibia in hamstring autograft anterior cruciate ligament reconstruction.METHODS:
A cohort of 233 sequential patients was analysed for graft failure rate and subjective IKDC, Tegner and Lysholm scores. 144 validated 1-year MRIs assessed and correlated graft healing and tunnel widening.RESULTS:
At mean follow-up of 28 months ± 8.2 [median 26, range 12-49], the graft failure rate was 4.7%. Significant improvements were seen in all clinical scores (p < 0.001). MRI analysis showed 71% with fully integrated grafts in the tibia and 24% in the femur, with the remainder all showing greater than 50% integration. Graft signal was low and homogenous in 67% in the tibia, 29% in the intra-articular portion and 20% in the femur. One patient had greater than 50% high signal in the tibial graft and one in the intra-articular graft, all others demonstrated greater than 50% low signal. Both graft integration and signal were significantly better in the tibia than the femur (p < 0.01). Tunnel widening was 2.2 ± 1.4 mm and 2.7 ± 1.3 mm in the tibia and femur, respectively. Comparison of individual MRI appearances and overall clinical outcome at the same 12-month point demonstrated no consistent significant correlation.CONCLUSION:
Adjustable cortical suspensory fixation in both femoral and tibial tunnels provides good clinical outcomes and a low graft rupture rate. Grafts demonstrate healing with comparatively low tunnel widening. There was no consistent significant correlation between the appearances on MRI and clinical outcome. LEVEL OF EVIDENCE Case-control study, Level III.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Tendões
/
Tíbia
/
Fêmur
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Reconstrução do Ligamento Cruzado Anterior
/
Lesões do Ligamento Cruzado Anterior
Tipo de estudo:
Etiology_studies
/
Incidence_studies
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Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Humans
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article