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Magnetic resonance angiography evaluation of the bone tunnel and graft following ACL reconstruction with a hamstring tendon autograft

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

In this study, magnetic resonance angiography (MRA) was performed in the early phase after anterior cruciate ligament (ACL) reconstruction to analyse the changes in nutrient blood vessels and blood flow to the femoral and tibial tunnels and the intraosseous tendon grafts.

Methods

The subjects were 30 patients who underwent single-bundle ACL reconstruction with an autogenous hamstring tendon. MRA was performed at 2, 3, and 6 months postoperatively (n = 10 at each time point). The mean overall signal-to-noise ratios (SNRs) in the tunnel regions and in the region of the tendon graft were compared in each femur and tibia.

Results

Blood vessels from arteries reached the femoral and tibial tunnels 2 months postoperatively. The tunnel walls showed high signal intensity, while the intraosseous tendon grafts had lower intensity. SNRs showed significant differences between the femoral and tibial tunnels overall and the intraosseous tendon grafts. At 3 and 6 months postoperatively, the signal intensity of the tunnel walls was decreased significantly, while that of the intraosseous tendon grafts was also decreased, but not significantly. At these times, the SNRs of the femoral and tibial tunnels did not differ significantly, both overall and in the region of the intraosseous tendon grafts.

Conclusion

Revascularization around the femoral and tibial tunnels occurred at 2 months postoperatively, with blood flow subsequently decreasing over time until 6 months. This revascularization may be involved in bone tendon healing and maturation of the tendon graft within the bone tunnels. Evaluations of revascularization by MRA may show the maturation stage of the graft and guide medical rehabilitation.

Level of evidence

IV.

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Conflict of interest

All authors disclose that they have no financial and/or personal relationships with other individuals or organizations that could influence this work.

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Authors and Affiliations

  1. Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan

    Ryu Terauchi, Yuji Arai, Shuji Nakagawa, Kazuya Ikoma, Keiichiro Ueshima, Toshiharu Shirai, Hiroyoshi Fujiwara & Toshikazu Kubo

  2. Department of Orthopaedics, Social Insurance Kyoto Hospital, Kyoto, Japan

    Kunio Hara & Ginjiro Minami

  3. Department of Radiology, Social Insurance Kyoto Hospital, Kyoto, Japan

    Takeshi Takahashi

Authors
  1. Ryu Terauchi
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  2. Yuji Arai
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  3. Kunio Hara
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  4. Ginjiro Minami
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  5. Shuji Nakagawa
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  6. Takeshi Takahashi
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  7. Kazuya Ikoma
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  8. Keiichiro Ueshima
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  9. Toshiharu Shirai
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  10. Hiroyoshi Fujiwara
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  11. Toshikazu Kubo
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Corresponding author

Correspondence to Yuji Arai.

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Terauchi, R., Arai, Y., Hara, K. et al. Magnetic resonance angiography evaluation of the bone tunnel and graft following ACL reconstruction with a hamstring tendon autograft. Knee Surg Sports Traumatol Arthrosc 24, 169–175 (2016). https://doi.org/10.1007/s00167-014-3358-x

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  • DOI: https://doi.org/10.1007/s00167-014-3358-x

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