2015 ISAKOS Biennial Congress ePoster #1327

Effect of Graft Bending Angle on the Graft Maturation in the Outside-In ACL Reconstruction Using A Retro-Reaming

Jin-Hwan Ahn, MD, Seoul KOREA, REPUBLIC OF
Yong-Seuk Lee, MD, PhD, Prof., Seongnam, Kyung-gi KOREA, REPUBLIC OF
Ji Woong Yoon, MD., Seoul KOREA, REPUBLIC OF

Department of Orthopedic Surgery, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, KOREA

FDA Status Cleared

Summary: MRI and 3-Dimensional CT Evaluation of the Reconstructed Anterior Cruciate Ligament using Retrograde Outside-In Technique 6months Postoperatively : Bending Angle Effect on Femoral Tunnel




The purposes of this study were 1) to evaluate the correlation between the femoral graft bending angle and magnetic resonance imaging signal intensity of the anterior cruciate ligament graft and 2) to analyze the difference of the magnetic resonance imaging signal intensity of the reconstructed anterior cruciate ligament graft depending on the area after single bundle anterior cruciate ligament (SB ACL) reconstruction using the outside-in technique with bone sparing retro-reaming.


Thirty-eight patients who underwent SB ACL reconstruction using the hamstring tendon autograft with the outside-in technique were enrolled in this study. All patients were assessed with 3-dimensional computed tomography to evaluate femoral tunnel factors: tunnel placement, tunnel length, tunnel diameter, femoral tunnel bending angle. 3.0-T MRI at a mean of 6.3±0.8 months after surgery to evaluate graft factors: graft signal intensity using the signal/noise quotient, the high signal-intensity lesion.


Femoral tunnel angle on the coronal plane had a correlation with signal/noise quotient values of the femoral intraosseous graft (p=0.003), but any other tunnel factors had not effects. The femoral intraosseous graft had higher signal intensity than other graft zone (p=0.009). Five cases (13.2%) showed high signal intensity zones around the femoral tunnel, but not around the tibial tunnel.


After ACL reconstruction using the outside-in technique, the graft bending angle showed a correlation with the femoral intraosseous graft signal intensity. This could imply that increased signal intensity by acute graft bending would be related to the lesser maturation of the graft.