Zhou Tianping, Xu Yihong, Zhang Aiai, Zhang Xuchao, Deng Kehan, Wu Haoran, Xu Weidong
Department of Joint Surgery and Sports Medicine, Changhai Hospital affiliated to Navy Medical University, Shanghai, China.
Department of Burn Surgery, Changhai Hospital affiliated to Navy Medical University, Shanghai, China.
Orthop J Sports Med. 2024 May 9;12(5):23259671241248202. doi: 10.1177/23259671241248202. eCollection 2024 May.
The relationship between graft maturity on magnetic resonance imaging (MRI) and return to sports (RTS) after anterior cruciate ligament (ACL) reconstruction is unclear.
To compare signal-to-noise quotient (SNQ) values and ACL graft T2* (gradient echo) values between patients who did RTS and those who did not RTS (NRTS) after ACL reconstruction and to evaluate the predictive value of T2* mapping for RTS after ACL reconstruction.
Case-control study; Level of evidence, 3.
At a minimum of 9 months after arthroscopic single-bundle ACL reconstruction with autologous hamstring tendon graft, 82 patients underwent RTS assessment as well as MRI evaluation. The patients were classified into RTS (n = 53) and NRTS (n = 29) groups based on the results of the assessment. The SNQ values in the proximal, middle, and distal regions of the graft and the T2* values of the graft were measured on MRI. The correlation between T2* values and RTS was assessed using Spearman correlation analysis. Receiver operating characteristic curves were constructed to compare the diagnostic performance, and the optimal T2* cutoff value for detecting RTS was determined based on the maximum Youden index.
At 9 months after ACL reconstruction, the proximal, middle, and mean SNQ values in the RTS group were significantly lower than those in the NRTS group (proximal: 17.15 ± 4.85 vs 19.55 ± 5.05, = .038; middle: 13.45 ± 5.15 vs. 17.75 ± 5.75, = .001; mean: 12.37 ± 2.74 vs 15.07 ± 3.32, < .001). The T2* values were lower in the RTS group (14.92 ± 2.28 vs 17.69 ± 2.48; < .001) and were correlated with RTS ( = -0.41; = .02). The area under the curve of T2* was 0.79 (95% CI, 0.75-0.83), and the optimal cutoff value for T2* was 16.65, with a sensitivity and specificity for predicting failure to RTS of 67.9% and 88.2%, respectively.
Study findings indicated that the SNQs (mean, proximal, and middle) and the T2* values of the graft in the RTS group were significantly lower than those in NRTS group. A T2* value of 16.65 was calculated to predict patients who failed RTS tests with a sensitivity of 67.9% and specificity of 88.2%.
前交叉韧带（ACL）重建术后，磁共振成像（MRI）显示的移植物成熟度与恢复运动（RTS）之间的关系尚不清楚。
比较ACL重建术后恢复运动（RTS）的患者与未恢复运动（NRTS）的患者之间的信噪比（SNQ）值和ACL移植物T2*（梯度回波）值，并评估T2*成像对ACL重建术后RTS的预测价值。
病例对照研究；证据等级，3级。
在采用自体腘绳肌腱移植物进行关节镜下单束ACL重建术后至少9个月，82例患者接受了RTS评估以及MRI检查。根据评估结果，将患者分为RTS组（n = 53）和NRTS组（n = 29）。在MRI上测量移植物近端、中部和远端区域的SNQ值以及移植物的T2值。采用Spearman相关分析评估T2值与RTS之间的相关性。绘制受试者工作特征曲线以比较诊断性能，并根据最大约登指数确定检测RTS的最佳T2*临界值。
ACL重建术后9个月，RTS组的近端、中部和平均SNQ值显著低于NRTS组（近端：17.15±4.85对19.55±5.05，P = 0.038；中部：13.45±5.15对17.75±5.75，P = 0.001；平均：12.37±2.74对15.07±3.32，P < 0.001）。RTS组的T2值较低（14.92±2.28对17.69±2.48；P < 0.001），且与RTS相关（r = -0.41；P = 0.02）。T2的曲线下面积为0.79（95%CI，0.75 - 0.83），T2*的最佳临界值为16.65，预测未恢复RTS的敏感度和特异度分别为67.9%和88.2%。
研究结果表明，RTS组移植物的SNQ（平均、近端和中部）值和T2值显著低于NRTS组。计算得出T2值为16.65时，预测未通过RTS测试患者的敏感度为67.9%，特异度为88.2%。
