Serial magnetic resonance imaging evaluation of operative site after fixation of patellar tendon graft with bioabsorbable interference screws in anterior cruciate ligament reconstruction.
Magnetic resonance imaging (MRI) is accepted as the imaging procedure of choice for showing internal derangement of the knee. In contrast to metal implants, bioabsorbable interference screws do not produce an artifact and provide an opportunity to expand the evaluation of the postoperative anterior cruciate ligament (ACL) ligament repair. There is the potential to evaluate the implant, the graft, the adjacent tissue, and the surgically created bone tunnels. The purpose of this study was to evaluate with MRI the postoperative site of ACL patellar tendon autografts in which bioabsorbable screws were used for fixation. It was hypothesized that a time line of bone tissue changes resulting from this type of surgery could be developed based on the expanded evaluation of MRI. From January 1993 through October 1997, 270 patients underwent surgical repair of a disrupted native ACL. There were 173 men 97 women; the average age was 25.1 years, (range, 17 to 50 years). There were 155 right knees and 115 left knees. In addition to the conventional postoperative clinical assessment and plain film radiographs, opportunistic MRIs were obtained with the patient's permission. The examinations were performed at different postoperative intervals from the third postoperative day to 4 years postoperatively. A total 206 MRIs from various time intervals were available for study. The study protocol was designed to look for loss of integrity of the screws, adjacent fluid collection, tunnel widening, and tunnel healing or narrowing. The hypothesis was substantiated in this study. The use of MRI provided observations not available by other imaging methods. The absence of metal implants for fixation provided an opportunity to examine the adjacent tissue in detail and to form a time line of the tissue response in this type of surgery.
Lajtai
G
G
Department of Traumatology, AKH, Wels, Austria. lajtai@netway.at
Noszian
I
I
Humer
K
K
Unger
F
F
Aitzetmüller
G
G
Orthner
E
E
D020341:Absorbable Implants; D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000473:pathology / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007719:Knee Joint / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010329:Patella / Q000473:pathology; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000295:instrumentation* / Q000379:methods; D012680:Sensitivity and Specificity; D013710:Tendons / Q000637:transplantation*; D016378:Tissue Transplantation / Q000379:methods