Usefulness of oblique coronal and sagittal MR images of the knee after double-bundle and selective anterior cruciate ligament reconstructions.

BACKGROUND: The use of double-bundle and selective-bundle anterior cruciate ligament (ACL) reconstruction is increasing. Few studies have been conducted to determine the diagnostic efficacy of additional oblique views of knee magnetic resonance imaging (MRI) for grading ACL graft injury for double-bundle and selective-bundle ACL reconstructions.
PURPOSE: To evaluate the diagnostic value of combining oblique coronal and sagittal imaging with orthogonal views for diagnosis of ACL graft failure after double-bundle or selective-bundle ACL reconstruction.
MATERIAL AND METHODS: This retrospective study included 64 patients who underwent double-bundle or selective-bundle ACL reconstruction surgery and received oblique coronal and oblique sagittal MRI of the knee. Subjective scoring of the images was performed by two radiologists who assessed the possibility of ACL graft failure based on full length view, full width view, and margin sharpness according to a 4-point scale. Diagnostic performance for ACL graft failure based on orthogonal views alone, ACL views alone, and orthogonal views with additional ACL views was evaluated by calculating the sensitivity, specificity, and accuracy.
RESULTS: The full length scores and total scores on ACL views were significantly higher than those of orthogonal views. The specificities and accuracies of diagnoses were highest for a combination of orthogonal, ACL sagittal, and ACL coronal views.
CONCLUSION: After double-bundle or selective-bundle ACL reconstruction, oblique sagittal and coronal images of the ACL provide better anatomic evaluation of the ACL than orthogonal views and specificity and accuracy of diagnoses were improved when oblique views were combined. © The Foundation Acta Radiologica 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.