title: Graft maturity of the reconstructed anterior cruciate ligament 6 months postoperatively: a magnetic resonance imaging evaluation of quadriceps tendon with bone block and hamstring tendon autografts.
abstract: OBJECTIVE
  The purpose of this study was to report the potential differences associated with graft maturity measured on magnetic resonance imaging (MRI) between quadriceps tendon with bone block and hamstring tendon autografts 6 months after ACL reconstruction.
  
  
  METHODS
  Twenty-six patients (15 male, 11 female; mean age 29.4 ± 17 years, range 13-46 years) who had undergone anatomic SB ACL reconstruction with either hamstring or quadriceps tendon with bone block autografts and had postoperative MRI 6 months after surgery. In 12 cases, the quadriceps tendon with bone block was used and hamstring in 14 cases. The signal/noise quotient was calculated to compare the difference between quadriceps tendon with bone block and hamstring autografts.
  
  
  RESULTS
  Mean signal/noise quotient is lesser in quadriceps tendon with bone block (1.74 ± 0.39) compared with HS (2.44 ± 0.61) autografts (p = 0.020). For hamstring autograft, the distal region showed a significantly lower mean signal/noise quotient value compared with middle region, and the mean signal/noise quotient value in proximal region was the highest (distal vs middle p < 0.001; middle vs proximal p = 0.007; proximal vs distal p < 0.001). The mean signal/noise quotient of proximal region in quadriceps tendon with bone block autograft was lesser than that in hamstring. The middle region of the quadriceps tendon with bone block graft demonstrated the greatest signal/noise quotient [distal vs middle p = 0.001; middle vs proximal p = 0.027; proximal vs distal (n.s.)].
  
  
  CONCLUSIONS
  The maturity of quadriceps tendon with bone block was better in comparison with hamstring 6 months after anatomic SB ACL reconstruction. This study is clinically relevant in that modifying the individual rehabilitation according to the extent of graft maturity may be necessary to optimize patient function and prevent re-injury of the ACL graft.
authors.affiliation: Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Yong
authors.initials: Y
authors.lastname: Ma
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Murawski
authors.forename: Amir Ata
authors.initials: AA
authors.lastname: Rahnemai-Azar
authors.forename: Catherine
authors.initials: C
authors.lastname: Maldjian
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Lynch
authors.forename: Freddie H
authors.initials: FH
authors.lastname: Fu
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods; D064592:Autografts / Q000637:transplantation*; D016025:Bone Transplantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011184:Postoperative Period; D012189:Retrospective Studies; D013710:Tendons / Q000637:transplantation*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult