Evaluation of changes in the length and cross-sectional dimension of autogenous grafts from semitendinosus and gracilis tendons used for anterior cruciate ligament (ACL) reconstruction in patients with active growth plates: MRI analysis

Abstract

Introduction. In recent years, there has been an increase in anterior cruciate ligament (ACL) injuries during childhood and adolescence. Aim. The aim of this study is to observe the diameter and length of the graft change in the postoperative period. Materials and methods. The study group consisted of 21 adolescents (11 boys and 10 girls) who underwent ACL reconstruction using hamstring and gracilis tendon grafts. MRI evaluations were performed at 3-6 and 24-26 months postoperatively to assess the width and length of the graft. The graft cross-sectional dimension was measured at the mid-substance of the tendons on sagittal scans in T1 and T2-weighted sequences. Length measurement was performed on axial ACL scans at its central portion (assessing mid-substance length). The collected measurements from both postoperative periods were compared and statistically analysed. Results. MRI analysis conducted postoperatively showed a statistically significant decrease in graft cross-sectional dimension, from an average 7.21-5.82 mm. The intra-articular graft length measured in MRI at 3-6 months post-surgery averaged 21.52 mm, while the length measured at 24-26 months post-surgery averaged 22.42 mm. Conclusions. Postoperative MRI analysis of reconstructed ACLs in adolescents with active growth plates demonstrated a reduction in graft cross-sectional dimension and a slight increase in graft length.