Partial ACL tears augmented with distally inserted hamstring tendons and over-the-top fixation: an MRI evaluation

Knee. 2008 Mar;15(2):111-6. doi: 10.1016/j.knee.2007.12.002. Epub 2008 Feb 8.

Abstract

This study evaluated the mid-term MRI appearance of partial ACL tear augmentation with quadrupled distally inserted hamstrings, while preserving the intact ACL bundle. Twenty-eight patients with ACL partial tear underwent augmentation. After 15-40 months follow-up, patients were evaluated clinically and by MRI. The mean IKDC score at follow-up was 93.8. Twenty-five patients were rated as excellent, three as fair. The mean tibial tunnel section area decreased by 27%. A correlation was noted between the clinical and MRI results: the graft was not visible or continuous with high intensity areas and the mean decrease in the tunnel section area was 3% in the three cases rated as fair. The graft appeared continuous and low intensity and the reduction in tibial tunnel section area was 30% in the cases with excellent clinical results. The residual part of the ACL was still recognizable in 79% of cases. The tibial hamstring attachment appeared normal in 93% of cases. In conclusion, excellent results correlated with a decrease in tunnel size and normal graft appearances on MRI. The poor results showed that the graft was not visible or not continuous, with high intensity areas and intra-ligamentous cystic formation within the tunnel. MRI scanning is useful in evaluating hamstring ACL grafts after reconstruction.

MeSH terms

  • Adult
  • Anterior Cruciate Ligament / pathology*
  • Anterior Cruciate Ligament / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Tendon Transfer / methods*
  • Tendons / pathology*
  • Tendons / surgery
  • Treatment Outcome