MR arthrography of anterior cruciate ligament reconstruction grafts.
OBJECTIVE
Our objective was to determine the accuracy of MR arthrography for identification of tears of anterior cruciate ligament reconstruction grafts and for detection of localized anterior arthrofibrosis and impingement.


METHODS
We retrospectively identified 27 patients (mean age, 31 years; range, 18-45 years) with anterior cruciate ligament reconstruction who had undergone MR arthrography followed by arthroscopy within 1 year. Three radiologists independently reviewed the MR arthrograms for the presence or absence of graft tear, localized anterior arthrofibrosis, and impingement.


RESULTS
Graft tears were identified with 100% sensitivity by all three reviewers with specificities of 100%, 89%, and 94%. Localized anterior arthrofibrosis was identified with 100% sensitivity by all reviewers, with specificities of 79%, 71%, and 38%. Impingement was detected with sensitivities and specificities of 83% and 100%, 83% and 52%, and 33% and 90% by the three reviewers, respectively. Interobserver agreement was almost perfect for detection of graft tear (kappa = 0.83, 0.92, and 0.83), was fair to moderate for detection of localized anterior arthrofibrosis (kappa = 0.50, 0.32, and 0.22), and was slight to fair for detection of impingement (kappa = 0.40, 0.08, and 0.35).


CONCLUSIONS
MR arthrography can accurately depict the presence of anterior cruciate ligament graft tears. Localized anterior arthrofibrosis and graft impingement were less accurately detected and showed greater observer variability.
Department of Diagnostic Radiology, Yale University School of Medicine, 333 Cedar St., New Haven, CT 06520, USA.
Thomas R
TR
McCauley
Amr
A
Elfar
Andrew
A
Moore
Andrew H
AH
Haims
Peter
P
Jokl
J Kevin
JK
Lynch
Patrick A
PA
Ruwe
Lee D
LD
Katz
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001175:Arthrography; D001182:Arthroscopy; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity