Comparison of sagittal obliquity of the reconstructed anterior cruciate ligament with native anterior cruciate ligament using magnetic resonance imaging.
OBJECTIVE
This study was conducted to compare the obliquity of asymptomatic anterior cruciate ligament (ACL) grafts with normal controls using sagittal magnetic resonance imaging (MRI).


METHODS
Case control study.


METHODS
Sagittal MRIs from 30 patients with a reconstructed ACL graft and from 30 individuals with an intact ACL were reviewed. Reconstructed patients were operated on with a 2-incision technique using a patellar tendon autograft. These selected patients had a normal or nearly normal IKDC score with a 3 mm or less anterior posterior translation on KT-1000 arthrometer testing compared with the intact knee. MRI showed a continuous and homogeneous graft without evidence of roof impingement. Obliquity of the grafted ACL was determined on each lateral MRI by measuring the intersection of the graft line with the tibial plateau plane. These figures were compared with data similarly obtained from 30 individuals with a stable knee and an intact ACL determined by history and physical examination.


RESULTS
Graft obliquity in reconstructed patients averaged 67 degrees with a range between 55 degrees and 81 degrees. In normal controls, intact ACL obliquity averaged 51 degrees with a range between 45 degrees and 55 degrees. The difference between the two groups was statistically significant (P <.0001).


CONCLUSIONS
MRIs of patients with an appropriate tibial tunnel placement in order to avoid notch impingement showed a continuous and homogeneous graft similar to the native ACL, but with a more vertical graft that does not recreate the normal sagittal obliquity. However, according to arthrometer testing, these more vertical grafts can control anterior posterior knee displacement.
Ayerza
Miguel A
MA
Institute of Orthopedics "Carlos E. Ottolenghi," Italian Hospital of Buenos Aires, Buenos Aires, Argentina. miguel.ayerza@hospitalitaliano.org.ar
Múscolo
D Luis
DL
Costa-Paz
Matías
M
Makino
Arturo
A
Rondón
Liliana
L
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000033:anatomy & histology / Q000473:pathology* / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D000886:Anthropometry; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies; D013710:Tendons / Q000637:transplantation; D014182:Transplantation, Autologous