title: MRI of double-bundle ACL reconstruction: evaluation of graft findings.
abstract: OBJECTIVE
  To demonstrate the magnetic resonance imaging (MRI) findings of double-bundle (DB) anterior cruciate ligament (ACL) reconstruction grafts.
  
  
  METHODS
  Sixty-six patients with DB ACL reconstruction were evaluated with MRI 2 years postoperatively. Graft thickness was measured separately by two musculoskeletal radiologists. The MRI findings of graft disruption, signal intensity (SI) changes, cystic degeneration, arthrofibrosis, and impingement were analyzed. The statistical significance of the association between MRI findings was calculated.
  
  
  RESULTS
  The mean anteromedial (AM) graft thickness was reduced 9% and the mean posterolateral (PL) graft thickness was reduced 18% from the original graft thickness. Disruption was seen in 3% of AM grafts and 6% of PL grafts and a partial tear in 8 and 23%, respectively. Both grafts were disrupted in 3% of patients. Increased SI was seen in 14% of intact AM grafts and in 60% of partially torn AM grafts (p = 0.032). In PL grafts the increased SI was seen in 51% of the intact grafts and in 93% of the partially torn grafts (p = 0.005). Cystic degeneration was seen in 8% of AM grafts and in 5% of PL grafts. Diffuse arthrofibrosis was seen in 5% of patients and a localized cyclops lesion in 3% of patients. Impingement of the AM graft was seen in 8% of patients.
  
  
  CONCLUSIONS
  Both grafts were disrupted in 3% of patients. Also, the frequencies of other complications were low. The use of orthogonal sequences in the evaluation of the PL graft SI seems to cause volume-averaging artefacts.
authors.affiliation: Medical Imaging Centre, Tampere University Hospital, FIN-33521, Tampere, Finland. tommi.kiekara@pshp.fi
authors.forename: Tommi
authors.initials: T
authors.lastname: Kiekara
authors.forename: Timo
authors.initials: T
authors.lastname: Järvelä
authors.forename: Heini
authors.initials: H
authors.lastname: Huhtala
authors.forename: Antti
authors.initials: A
authors.lastname: Paakkala
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000473:pathology* / Q000601:surgery / Q000637:transplantation*; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D019737:Transplants; D016896:Treatment Outcome