MRI signs of anterior cruciate ligament graft restructuring in bone canal

Abstract

One of the reason for succeed anterior cruciate ligament reconstruction is the process of graft remodeling on the border «tendon-bone» in the bone canal. This factor can influence on the mechanical stability of the knee joint after anterior cru­ciate ligament reconstruction and can determine the rehabilitation exercises.Objective: to work out MRI criteria of graft reconstruction in bone canals.Methods: we included 90 patients, who were divided into two groups: the 1st o ne ( 47) w e used the technique «all-inside», in the 2nd group (43) — cross transtibial drilling technique. In 8 patients MRI was made.Results: we suggested the next criteria for the assessment of graft reconstruction in femoral and tibia bone canals: 1) signs of reconstruction on the border «tendon-bone»; 2) synovial fluid in the bone canals; 3) femoral and tibia bone marrow edema. Number of patients with the 1st stage (full graft reconstruction) without synovial fluid in bone canal increased in follow up period 3 to 9 months. Number of patients without bone marrow edema increased in follow up 3 to 12 months (35,6; 54,4; 74,5 and 84,5 %). It was shown in 6 months that in the 1st group there was a prevalence of patients (60 %) with the 1st stage of reconstruc­tion compare with the 2nd group (42,2 %). As for the presence of synovial fluid in bone canal we observed a reliable difference in 3 months — 75,5 % in the 1st group compare with 78,9 % — in the 2nd.Conclusions: the dynamic of the graft reconstruction gets on the top till 9 months after surgery and after remains unchanged. The technique «all-inside» contributes faster and more qualitative graft reconstruction due to fewer trauma to the proxi­mal part of the tibia and absence of screws in the tibia canal.