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Hamstring Anterior Cruciate Ligament Reconstruction using an Adjustable-Loop Cortical Suspension Device: Immediate Post-Operative Magnetic Resonance Imaging
Author(s):
Choi N. (South Korea (ROK))
,
Choi N. (South Korea (ROK))
Affiliations:
Jung Y.
,
Jung Y.
Affiliations:
Kim B.
,
Kim B.
Affiliations:
Oh W.
Oh W.
Affiliations:
ESSKA Academy. Choi N. 05/09/18; 209455; P06-259 Topic: Arthroscopic Surgery
Nam-Hong Choi
Nam-Hong Choi
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Abstract
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Objectives: Although the adjustable-loop fixation device can pull the hamstring graft theoretically, no previous studies have demonstrated whether the hamstring graft is fully inserted into the femoral tunnel using magnetic resonance imaging (MRI) at immediate postoperative day. The purpose of this retrospective study was to elucidate MRI evaluations at immediate postoperative day after hamstring ACL reconstructions using the adjustable-loop fixation device.

Methods: Inclusion criteria were consecutive 62 patients who underwent hamstring ACL reconstructions using the adjustable-loop cortical fixation device for the femoral fixation and the a sheath and screw for the tibial fixation between October 2015 and December 2016. Postoperatively, 3-T MR scan were checked before weight bearing after surgery in all patients to evaluate position of the hamstring graft within the femoral tunnel. Using the 3-T MRI, a 3D PD sampling perfection with application-optimized contrasts using different flip angle evolution (SPACE) was acquired in the sagittal plane. 3D PD SPACE sequences were subsequently reformatted into coronal images to view the entire length of the femoral tunnel by a MR technologist on an MR console by using commercially available software. The reformation was performed with 0.5-mm slice-thickness. While reviewing multiplanar reformatted images, a coronal image showing a maximum length of the femoral tunnel was chosen. The distance (the tunnel-graft gap) between the top of the femoral tunnel and the top of the hamstring graft was measured.

Results: Follow-up 3-T MRI reformatted image showed that the tunnel-graft gap was 1.5 ± 2.7 mm (range, 0 -12 mm). In 43 (69.4%) patients, there was no gap between the top of the femoral tunnel and the hamstring graft. In 19 (30.6%) patients, there was a gap between the tunnel and graft, and 9 (14.5%) patients showed the tunnel-graft gap more than 5 mm.

Conclusions: The hamstring graft may not be fully inserted into the femoral tunnel after using an adjustable-loop cortical suspension device.

Keywords:
hamstring, ACL, adjustable-loop cortical suspension device, MRI
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