Kanamiya Takeshi, Hara Michiya, Naito Masatoshi
Department of Orthopaedic Surgery, Fukuoka University School of Medicine, Fukuoka, Japan.
Clin Orthop Relat Res. 2004 Feb(419):202-6. doi: 10.1097/00003086-200402000-00033.
Several studies have shown the accuracy of magnetic resonance imaging in evaluating the reconstructed anterior cruciate ligament. The purpose of the current study was to clarify the clinical usefulness of magnetic resonance imaging for evaluating the reconstructed anterior cruciate ligament in comparison with using arthroscopy. Sixty-nine patients who had an anterior cruciate ligament reconstruction using a bone-tendon-bone autograft were examined by magnetic resonance imaging and arthroscopy an average of 12 months after surgery. There were 41 males and 28 females with an average age of 25.9 years (range, 15-66 years). The interval from surgery to the magnetic resonance imaging or arthroscopic evaluation was a mean of 12 months (range, 4-32 months). The magnetic resonance imaging findings of the reconstructed anterior cruciate ligament were classified as either high, intermediate, or low intensity. The arthroscopic findings also were classified as either graft impingement at the intercondylar notch or no impingement. In the 47 anterior cruciate ligament grafts that were not impinged, the signal intensity remained low and did not increase during second-look arthroscopy. In contrast, 22 anterior cruciate ligament grafts that were impinged showed an increased signal intensity in the distal area of the graft at the time of the second-look arthroscopy. Furthermore, no significant correlation was observed between the presence of a high signal intensity and postoperative instability. The high signal intensity of the anterior cruciate ligament graft on magnetic resonance imaging was found to be caused by graft impingement. These findings therefore show a clear association between graft impingement and the subsequent appearance of the graft on magnetic resonance imaging.
多项研究表明磁共振成像在评估重建的前交叉韧带方面具有准确性。本研究的目的是阐明与关节镜检查相比，磁共振成像在评估重建的前交叉韧带方面的临床实用性。对69例使用骨-肌腱-骨自体移植物进行前交叉韧带重建的患者在术后平均12个月时进行了磁共振成像和关节镜检查。其中男性41例，女性28例，平均年龄25.9岁（范围15 - 66岁）。从手术到磁共振成像或关节镜评估的间隔平均为12个月（范围4 - 32个月）。重建的前交叉韧带的磁共振成像表现分为高、中、低强度。关节镜检查结果也分为髁间窝移植物撞击或无撞击。在47例未发生撞击的前交叉韧带移植物中，信号强度保持较低，在二次关节镜检查时未增加。相比之下，22例发生撞击的前交叉韧带移植物在二次关节镜检查时在移植物远端区域显示信号强度增加。此外，高信号强度的存在与术后不稳定之间未观察到显著相关性。发现磁共振成像上前交叉韧带移植物的高信号强度是由移植物撞击引起的。因此，这些发现表明移植物撞击与随后磁共振成像上移植物的表现之间存在明显关联。
