Summary

Conventional X Rays is a valid and cheap option to identify ACLR failure

Abstract

Introduction

Anterior cruciate ligament reconstruction (ACLR) gives very good but not ideal results. Radiological evaluation of ACL tunnel placement is very important and mandatory before any revision.

Aim/Hypothesis:
To correlate between radiological parameters and clinical results of ACLR and to compare between conventional X Ray and CT scans as tools of assessment. Our hypothesis was that good X Ray parameters would indicate good clinical results.

Methods

We retrospectively evaluated ACLR patients in our institute from January 2012 till December 2015.
Conventional plain X Rays (Antero-Posterior and Lateral views) and Multi-slice CT were done for evaluation. Patient was considered to have anatomical ACLR if both femoral and tibial tunnels were anatomical.
Patients were assessed clinically by Lysholm and IKDC scores.

Results

Our database revealed 200 ACLR during study period. Out of these; 70 were done by interference screws and hamstring tendon graft with more than 2 years follow up. Seven patients refused to participate and 3 patients couldn't be reached leaving 60 patients included in this study.
Forty-six patients had anatomical femoral and tibial tunnel placement whilst both tunnels were non anatomical in 9 cases. Femoral tunnel was high in 3 patients and tibial tunnel was posterior in 2 patients.
Good clinical outcome was positively correlated with proper radiological parameters. There was no significant difference between CT scans and Plain X Rays Measurements.

Conclusion

The logical conclusion is that satisfactory clinical outcome correlates with proper radiological measures. Conventional X Rays can help identify ACLR failure and this constitutes a cheaper option than CT and more importantly less radiation exposure.