Graft maturity of the reconstructed anterior cruciate ligament 6 months postoperatively: a magnetic resonance imaging evaluation of quadriceps tendon with bone block and hamstring tendon autografts

Yong Ma; Christopher D. Murawski; Amir Ata Rahnemai-Azar; Catherine Maldjian; Andrew D. Lynch; Freddie H. Fu

doi:10.1007/s00167-014-3302-0

Graft maturity of the reconstructed anterior cruciate ligament 6 months postoperatively: a magnetic resonance imaging evaluation of quadriceps tendon with bone block and hamstring tendon autografts

Yong Ma, Christopher D. Murawski, Amir Ata Rahnemai-Azar, Catherine Maldjian, Andrew D. Lynch, Freddie H. Fu

Research output: Contribution to journal › Article › peer-review

74 Scopus citations

Abstract

Purpose: The purpose of this study was to report the potential differences associated with graft maturity measured on magnetic resonance imaging (MRI) between quadriceps tendon with bone block and hamstring tendon autografts 6 months after ACL reconstruction. Methods: Twenty-six patients (15 male, 11 female; mean age 29.4 ± 17 years, range 13–46 years) who had undergone anatomic SB ACL reconstruction with either hamstring or quadriceps tendon with bone block autografts and had postoperative MRI 6 months after surgery. In 12 cases, the quadriceps tendon with bone block was used and hamstring in 14 cases. The signal/noise quotient was calculated to compare the difference between quadriceps tendon with bone block and hamstring autografts. Results: Mean signal/noise quotient is lesser in quadriceps tendon with bone block (1.74 ± 0.39) compared with HS (2.44 ± 0.61) autografts (p = 0.020). For hamstring autograft, the distal region showed a significantly lower mean signal/noise quotient value compared with middle region, and the mean signal/noise quotient value in proximal region was the highest (distal vs middle p < 0.001; middle vs proximal p = 0.007; proximal vs distal p < 0.001). The mean signal/noise quotient of proximal region in quadriceps tendon with bone block autograft was lesser than that in hamstring. The middle region of the quadriceps tendon with bone block graft demonstrated the greatest signal/noise quotient [distal vs middle p = 0.001; middle vs proximal p = 0.027; proximal vs distal (n.s.)]. Conclusion: The maturity of quadriceps tendon with bone block was better in comparison with hamstring 6 months after anatomic SB ACL reconstruction. This study is clinically relevant in that modifying the individual rehabilitation according to the extent of graft maturity may be necessary to optimize patient function and prevent re-injury of the ACL graft. Level of evidence: Retrospective case series, Level IV.

Original language	English (US)
Pages (from-to)	661-668
Number of pages	8
Journal	Knee Surgery, Sports Traumatology, Arthroscopy
Volume	23
Issue number	3
DOIs	https://doi.org/10.1007/s00167-014-3302-0
State	Published - Mar 2015
Externally published	Yes

Keywords

ACL
Anatomic
Autograft
MRI
Postoperative
Signal intensity

ASJC Scopus subject areas

Surgery
Orthopedics and Sports Medicine

Access to Document

10.1007/s00167-014-3302-0

Cite this

Ma, Y., Murawski, C. D., Rahnemai-Azar, A. A., Maldjian, C., Lynch, A. D., & Fu, F. H. (2015). Graft maturity of the reconstructed anterior cruciate ligament 6 months postoperatively: a magnetic resonance imaging evaluation of quadriceps tendon with bone block and hamstring tendon autografts. Knee Surgery, Sports Traumatology, Arthroscopy, 23(3), 661-668. https://doi.org/10.1007/s00167-014-3302-0

Graft maturity of the reconstructed anterior cruciate ligament 6 months postoperatively: a magnetic resonance imaging evaluation of quadriceps tendon with bone block and hamstring tendon autografts. / Ma, Yong; Murawski, Christopher D.; Rahnemai-Azar, Amir Ata et al.
In: Knee Surgery, Sports Traumatology, Arthroscopy, Vol. 23, No. 3, 03.2015, p. 661-668.

Research output: Contribution to journal › Article › peer-review

Ma, Y, Murawski, CD, Rahnemai-Azar, AA, Maldjian, C, Lynch, AD & Fu, FH 2015, 'Graft maturity of the reconstructed anterior cruciate ligament 6 months postoperatively: a magnetic resonance imaging evaluation of quadriceps tendon with bone block and hamstring tendon autografts', Knee Surgery, Sports Traumatology, Arthroscopy, vol. 23, no. 3, pp. 661-668. https://doi.org/10.1007/s00167-014-3302-0

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title = "Graft maturity of the reconstructed anterior cruciate ligament 6 months postoperatively: a magnetic resonance imaging evaluation of quadriceps tendon with bone block and hamstring tendon autografts",

abstract = "Purpose: The purpose of this study was to report the potential differences associated with graft maturity measured on magnetic resonance imaging (MRI) between quadriceps tendon with bone block and hamstring tendon autografts 6 months after ACL reconstruction. Methods: Twenty-six patients (15 male, 11 female; mean age 29.4 ± 17 years, range 13–46 years) who had undergone anatomic SB ACL reconstruction with either hamstring or quadriceps tendon with bone block autografts and had postoperative MRI 6 months after surgery. In 12 cases, the quadriceps tendon with bone block was used and hamstring in 14 cases. The signal/noise quotient was calculated to compare the difference between quadriceps tendon with bone block and hamstring autografts. Results: Mean signal/noise quotient is lesser in quadriceps tendon with bone block (1.74 ± 0.39) compared with HS (2.44 ± 0.61) autografts (p = 0.020). For hamstring autograft, the distal region showed a significantly lower mean signal/noise quotient value compared with middle region, and the mean signal/noise quotient value in proximal region was the highest (distal vs middle p < 0.001; middle vs proximal p = 0.007; proximal vs distal p < 0.001). The mean signal/noise quotient of proximal region in quadriceps tendon with bone block autograft was lesser than that in hamstring. The middle region of the quadriceps tendon with bone block graft demonstrated the greatest signal/noise quotient [distal vs middle p = 0.001; middle vs proximal p = 0.027; proximal vs distal (n.s.)]. Conclusion: The maturity of quadriceps tendon with bone block was better in comparison with hamstring 6 months after anatomic SB ACL reconstruction. This study is clinically relevant in that modifying the individual rehabilitation according to the extent of graft maturity may be necessary to optimize patient function and prevent re-injury of the ACL graft. Level of evidence: Retrospective case series, Level IV.",

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AU - Maldjian, Catherine

AU - Lynch, Andrew D.

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N2 - Purpose: The purpose of this study was to report the potential differences associated with graft maturity measured on magnetic resonance imaging (MRI) between quadriceps tendon with bone block and hamstring tendon autografts 6 months after ACL reconstruction. Methods: Twenty-six patients (15 male, 11 female; mean age 29.4 ± 17 years, range 13–46 years) who had undergone anatomic SB ACL reconstruction with either hamstring or quadriceps tendon with bone block autografts and had postoperative MRI 6 months after surgery. In 12 cases, the quadriceps tendon with bone block was used and hamstring in 14 cases. The signal/noise quotient was calculated to compare the difference between quadriceps tendon with bone block and hamstring autografts. Results: Mean signal/noise quotient is lesser in quadriceps tendon with bone block (1.74 ± 0.39) compared with HS (2.44 ± 0.61) autografts (p = 0.020). For hamstring autograft, the distal region showed a significantly lower mean signal/noise quotient value compared with middle region, and the mean signal/noise quotient value in proximal region was the highest (distal vs middle p < 0.001; middle vs proximal p = 0.007; proximal vs distal p < 0.001). The mean signal/noise quotient of proximal region in quadriceps tendon with bone block autograft was lesser than that in hamstring. The middle region of the quadriceps tendon with bone block graft demonstrated the greatest signal/noise quotient [distal vs middle p = 0.001; middle vs proximal p = 0.027; proximal vs distal (n.s.)]. Conclusion: The maturity of quadriceps tendon with bone block was better in comparison with hamstring 6 months after anatomic SB ACL reconstruction. This study is clinically relevant in that modifying the individual rehabilitation according to the extent of graft maturity may be necessary to optimize patient function and prevent re-injury of the ACL graft. Level of evidence: Retrospective case series, Level IV.

AB - Purpose: The purpose of this study was to report the potential differences associated with graft maturity measured on magnetic resonance imaging (MRI) between quadriceps tendon with bone block and hamstring tendon autografts 6 months after ACL reconstruction. Methods: Twenty-six patients (15 male, 11 female; mean age 29.4 ± 17 years, range 13–46 years) who had undergone anatomic SB ACL reconstruction with either hamstring or quadriceps tendon with bone block autografts and had postoperative MRI 6 months after surgery. In 12 cases, the quadriceps tendon with bone block was used and hamstring in 14 cases. The signal/noise quotient was calculated to compare the difference between quadriceps tendon with bone block and hamstring autografts. Results: Mean signal/noise quotient is lesser in quadriceps tendon with bone block (1.74 ± 0.39) compared with HS (2.44 ± 0.61) autografts (p = 0.020). For hamstring autograft, the distal region showed a significantly lower mean signal/noise quotient value compared with middle region, and the mean signal/noise quotient value in proximal region was the highest (distal vs middle p < 0.001; middle vs proximal p = 0.007; proximal vs distal p < 0.001). The mean signal/noise quotient of proximal region in quadriceps tendon with bone block autograft was lesser than that in hamstring. The middle region of the quadriceps tendon with bone block graft demonstrated the greatest signal/noise quotient [distal vs middle p = 0.001; middle vs proximal p = 0.027; proximal vs distal (n.s.)]. Conclusion: The maturity of quadriceps tendon with bone block was better in comparison with hamstring 6 months after anatomic SB ACL reconstruction. This study is clinically relevant in that modifying the individual rehabilitation according to the extent of graft maturity may be necessary to optimize patient function and prevent re-injury of the ACL graft. Level of evidence: Retrospective case series, Level IV.

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KW - Signal intensity

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