title: A descriptive study of potential effect of anterior tibial translation, femoral tunnel and anterior cruciate ligament graft inclination on clinical outcome and degenerative changes.
abstract: There is no evidence that anatomically correct anterior cruciate ligament reconstruction (ACLR) offers lower rate of degenerative changes development or that it would lead to a better outcome. The significance and understanding of the abnormal anterior tibial translation (ATT) in ACLR patients is yet to be established.
  
  
  
  Sixty subjects (40 patients at 5.9 years after ACLR, 20 healthy controls) underwent 3 T MRI. Quantitative cartilage T2 mapping and morphological whole organ magnetic resonance imaging score (WORMS) evaluation was performed. Self-reported questionnaires were used for subjective clinical evaluation. Correlations were calculated with the following MRI measurements; femoral tunnel inclination, ACL graft inclination, lateral and medial compartment ATT.
  
  
  
  In the ACLR group positive correlation was found between the patellar cartilage T2 values and sagittal ACL graft inclination. In the ACLR group lateral compartment ATT showed negative correlation with ACL graft inclination and subjective clinical evaluation, and positive correlation with morphological degenerative changes. Femoral tunnel showed positive correlation with ACL graft inclination in the same plane.
  
  
  
  Increased ATT offers worse clinical outcome and increased rate of degenerative changes. Furthermore, ATT is affected by the ACL inclination. Inclination of the drilling tunnel affects ACL graft inclination; thereby independent drilling techniques provide superior results of anatomical ACL graft positioning.
authors.affiliation: Institute of Radiology, University Medical Centre Ljubljana, Zaloška 7, 1000, Ljubljana, Slovenia. ziga.snoj@gmail.com.
authors.forename: Žiga
authors.initials: Ž
authors.lastname: Snoj
authors.affiliation: Department of Orthopaedic Surgery of the Ljubljana University Medical Centre, Zaloška 9, 1000, Ljubljana, Slovenia.
authors.forename: Oskar
authors.initials: O
authors.lastname: Zupanc
authors.affiliation: Department of Orthopaedic Surgery of the Ljubljana University Medical Centre, Zaloška 9, 1000, Ljubljana, Slovenia.
authors.forename: Klemen
authors.initials: K
authors.lastname: Stražar
authors.affiliation: Institute of Radiology, University Medical Centre Ljubljana, Zaloška 7, 1000, Ljubljana, Slovenia.
authors.forename: Vladka
authors.initials: V
authors.lastname: Salapura
mesh_terms: D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries / Q000503:physiopathology / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001696:Biomechanical Phenomena; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D007719:Knee Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: ACL reconstruction; Anterior tibial translation; MRI; Osteoarthritis; T2 mapping