Abstract
BackgroundAnterior cruciate ligament (ACL) reconstruction is a common orthopaedic procedure. We developed a novel, low dose computed tomography (LDCT) protocol to assess tunnel position post-operatively. The effective radiation dose of this protocol is < 0.5millisieverts (mSv), which is significantly less than the 2 mSv dose for a conventional CT protocol. The aim of this study was to assess the accuracy of the LDCT protocol for determining tunnel position.MethodsTwenty-six patients who underwent primary ACL reconstruction were included in the study. A LDCT scan was performed 6 weeks post-operatively. Femoral and tibial tunnel positions were measured on three dimensional (3D) reconstructions using previously validated techniques. Measurements were performed independently by three observers at two time points, 4 weeks apart.ResultsThere was excellent intra- and inter-rater reliability for all measurements using the images obtained from the LDCT protocol. Intra-class correlation coefficient (ICC) values were > 0.9 for all measurements.ConclusionsThe LDCT protocol described in this study accurately demonstrates femoral and tibial tunnels post ACL reconstruction, while exposing the patient to a quarter of the radiation dose of a conventional CT. This protocol could be used by orthopaedic surgeons for routine post-operative imaging, in place of plain film radiographs.
Highlights
Anterior cruciate ligament (ACL) reconstruction is a common orthopaedic procedure
We developed a novel low dose computed tomography (LDCT) protocol, with the goal of accurately assessing tunnel position post ACL reconstruction, while minimising radiation exposure to the patient
Patients undergoing isolated primary ACL reconstruction by the senior author (PG) over a 12-month period were prospectively recruited to the study
Summary
Anterior cruciate ligament (ACL) reconstruction is a common orthopaedic procedure. Low dose computed tomography (LDCT) protocol to assess tunnel position post-operatively. The aim of this study was to assess the accuracy of the LDCT protocol for determining tunnel position. Rupture of the ACL is a common sporting injury [1]. ACL reconstruction is an effective orthopaedic procedure, allowing return to sporting activity after appropriate rehabilitation [2]. Graft rupture is a common complication, occurring in up to 20% of cases, with younger patients being at higher risk [3]. Tunnel position may be assessed post operatively using a number of imaging modalities. A number of techniques have been proposed to determine correct tunnel position [7].
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