title: Specific compartmental analysis of cartilage status in double-bundle ACL reconstruction patients: a comparative study using pre- and postoperative MR images.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the changes in the site-specific cartilage status after a double-bundle ACL reconstruction using preoperative and follow-up MR images.
  
  
  METHODS
  Thirty-six knees that underwent a double-bundle ACL reconstruction from 2001 to 2009 with the available preoperative and follow-up magnetic resonance imaging were included. Patients with a meniscal injury were compared with those without a meniscal injury. The cartilage morphology was classified using a 6-grade scale [from 0 = normal thickness and signal, to 6 = diffuse full-thickness loss (>75 % of the region)]. The changes in cartilage status were evaluated at 14 sites.
  
  
  RESULTS
  Cartilage changes were observed in all sites and were classified according to the site and degree of change. The majority of changes were grade 0 and 1, which accounted for 68 and 16.8 % of changes, respectively. The patella medial facet and anterolateral and centromedial femoral regions showed significantly more cartilage loss than the posteromedial, centrolateral, anterolateral, and anteromedial tibial regions. No significance was observed between the knees with or without combined injuries (n.s.). On the other hand, knees with or without combined injuries showed a different pattern of cartilage change, as demonstrated by different levels of grade change at sites.
  
  
  CONCLUSIONS
  The change in cartilage status was minimal after a double-bundle ACL reconstruction. The patella medial facet, lateral femur anterior region, and medial femur central region showed significantly more cartilage loss than the medial tibia posterior, lateral tibia central, lateral tibia anterior, and medial tibia anterior regions. The presence of a combined injury did not affect the cartilage status changes, even though it was underpowered and too short term to assess the influence of the meniscal injury.
  
  
  METHODS
  Case series, Level IV.
authors.affiliation: Department of Orthopedic Surgery, Gil Medical Center, Gachon University, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760, Korea. smcos1@hanmail.net
authors.forename: Yong Seuk
authors.initials: YS
authors.lastname: Lee
authors.forename: Yu Mi
authors.initials: YM
authors.lastname: Jeong
authors.forename: Jae Ang
authors.initials: JA
authors.lastname: Sim
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Kwak
authors.forename: Kwang Hee
authors.initials: KH
authors.lastname: Kim
authors.forename: Shin Woo
authors.initials: SW
authors.lastname: Nam
authors.forename: Beom Koo
authors.initials: BK
authors.lastname: Lee
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000009:adverse effects; D002356:Cartilage / Q000473:pathology*; D002357:Cartilage Diseases / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D000070600:Tibial Meniscus Injuries; D055815:Young Adult