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The Relationship Between ACL Femoral Tunnel Position and Postoperative MRI Signal Intensity.

Abstract The purpose of this study was to find the ideal femoral tunnel position in single-bundle anterior cruciate ligament (ACL) reconstruction using three-dimensional computed tomography (3D-CT) by comparing clinical scores, stability of the knee joint, and graft signal intensity on follow-up magnetic resonance imaging (MRI). We hypothesized that positioning the femoral tunnel near the anteromedial bundle or center would lead to better results in terms of clinical outcomes and graft signal intensity on follow-up MRI than would positioning the tunnel near the posterolateral bundle.
PMID
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Authors

Mayor MeshTerms

Magnetic Resonance Imaging

Keywords
Journal Title the journal of bone and joint surgery. american volume
Publication Year Start




PMID- 28244908
OWN - NLM
STAT- MEDLINE
DA  - 20170228
DCOM- 20170308
LR  - 20170308
IS  - 1535-1386 (Electronic)
IS  - 0021-9355 (Linking)
VI  - 99
IP  - 5
DP  - 2017 Mar 01
TI  - The Relationship Between ACL Femoral Tunnel Position and Postoperative MRI Signal
      Intensity.
PG  - 379-387
LID - 10.2106/JBJS.16.00241 [doi]
AB  - BACKGROUND: The purpose of this study was to find the ideal femoral tunnel
      position in single-bundle anterior cruciate ligament (ACL) reconstruction using
      three-dimensional computed tomography (3D-CT) by comparing clinical scores,
      stability of the knee joint, and graft signal intensity on follow-up magnetic
      resonance imaging (MRI). We hypothesized that positioning the femoral tunnel near
      the anteromedial bundle or center would lead to better results in terms of
      clinical outcomes and graft signal intensity on follow-up MRI than would
      positioning the tunnel near the posterolateral bundle. METHODS: Two hundred
      patients underwent arthroscopic single-bundle ACL reconstruction with a
      soft-tissue graft; all patients had the same surgeon, surgical technique
      (anteromedial transportal technique), and rehabilitation protocol. Each patient
      underwent 3D-CT within 1 week after the operation and MRI at 1 year after the
      operation. Outcomes were evaluated in terms of clinical scores and the stability 
      of the knee joint. We classified patients into three groups based on the femoral 
      tunnel position: the anteromedial position group, the posterolateral position
      group, and the center position group. We evaluated graft signal intensity on
      follow-up MRI. RESULTS: This study included 77 patients: 25 patients in the
      anteromedial position group, 15 patients in the posterolateral position group,
      and 33 patients in the center position group. Four patients had an eccentric
      tunnel position and were excluded. The 3 groups did not differ significantly (p >
      0.05) in preoperative demographic characteristics. There were no significant
      differences (p > 0.05) between groups in clinical outcomes. However, patients in 
      the anteromedial position group and in the center position group had better graft
      signal intensity on follow-up MRI than those in the posterolateral position
      group. CONCLUSIONS: Positioning the femoral tunnel near the anteromedial bundle
      and center led to better graft signal intensity on follow-up MRI in anatomic
      single-bundle ACL reconstruction than did positioning the femoral tunnel near the
      posterolateral bundle. There were no differences in clinical scores or stability 
      of the knee joint among the three groups. LEVEL OF EVIDENCE: Therapeutic Level
      II. See Instructions for Authors for a complete description of levels of
      evidence.
FAU - Lee, Se Min
AU  - Lee SM
AD  - 1Department of Orthopaedic Surgery, Graduate School (S.M.L.), College of Medicine
      (K.H.Y. and D.H.), Kyung Hee University, Seoul, South Korea 2Department of
      Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, South
      Korea.
FAU - Yoon, Kyoung Ho
AU  - Yoon KH
FAU - Lee, Sang Hak
AU  - Lee SH
FAU - Hur, Dong
AU  - Hur D
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - United States
TA  - J Bone Joint Surg Am
JT  - The Journal of bone and joint surgery. American volume
JID - 0014030
SB  - AIM
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Anterior Cruciate Ligament Injuries/diagnostic imaging/*surgery
MH  - Anterior Cruciate Ligament Reconstruction/*methods
MH  - Arthroscopy
MH  - Female
MH  - Femur/*diagnostic imaging/*surgery
MH  - Humans
MH  - Imaging, Three-Dimensional
MH  - *Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Postoperative Period
MH  - Prospective Studies
MH  - Tomography, X-Ray Computed
MH  - Transplants/diagnostic imaging
MH  - Young Adult
EDAT- 2017/03/01 06:00
MHDA- 2017/03/09 06:00
CRDT- 2017/03/01 06:00
AID - 10.2106/JBJS.16.00241 [doi]
AID - 00004623-201703010-00003 [pii]
PST - ppublish
SO  - J Bone Joint Surg Am. 2017 Mar 1;99(5):379-387. doi: 10.2106/JBJS.16.00241.

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