[Assessment with magnetic resonance of reconstruction of the posterior cruciate ligament. Preliminary experience].
Posterior cruciate ligament (PCL) tears are definitely less common than anterior cruciate ligament (ACL) tears: their incidence in literature ranges 3-20% of all capsuloligamentous injuries versus 45-90% for ACL tears. Recent papers reported that if these injuries are not operated on, they evolve first into medial femorotibial and femoropatellar arthrosis and then into tricompartmental arthrosis. There are several MR studies dealing with ACL reconstruction, while MR studies on PCL reconstruction are lacking, both because the frequency of the latter injuries is lower and because they are difficult to demonstrate. We report our preliminary experience with PCL reconstruction studied with MRI in 12 patients submitted to arthroscopy. We used the ipsilateral patellar tendon (11 cases) or the contralateral one (1 case). The patients were submitted to MRI 4-16 months after surgery. Axial, coronal and sagittal images were acquired, together with oblique sagittal and coronal slices to show the graft completely. We also used SE, GE and fat suppression STIR MR sequences, trying to identify which of them are the most useful in patients with healing or exudative reaction in the intercondylar notch. MR exams were performed with a dedicated permanent magnet (0.2 T) and a permanent total body unit (0.3 T). The graft was clearly depicted on all images in 11 patients, while graft retear was shown in 1 patient. MRI did depict the whole graft in all patients, which finding is useful to study the signal intensity changes which indicate graft trophism. MRI also depicted correctly the femoral and tibial tunnel position and alignment, the presence of possible impingement with bone, the presence and extent of the healing reaction or of serum-hematic material in the intercondylar notch. The latter factor prevents the graft depiction, in which case the MR techniques providing the highest possible contrast in the different structures under examination are mandatory. Finally, MRI permitted to study possible associated capsuloligamentous or meniscal injuries and the state of femorotibial and femoropatellar chondral covering, the presence of articular synovia changes and the amount of possible joint effusion. We believe that MRI exhibited a high standard of sensitivity, versatility and diagnostic accuracy in the examination of surgical patients submitted to arthroscopic PCL reconstruction. Further studies and long-term follow-up will help define the use of MRI in these patients.
Bellelli
A
A
Radiologia Diagnostica, Ospedale, San Pietro Fatebenefratelli, Roma.
Adriani
E
E
Maresca
G
G
Nardis
P F
PF
Mariani
P P
PP
D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016119:Posterior Cruciate Ligament / Q000293:injuries* / Q000473:pathology* / Q000601:surgery