Magda Marcon1,2, Bernhard Ciritsis3, Christoph Laux3, Daniel Nanz1, Michael A Fischer1,4, Gustav Andreisek1, Erika J Ulbrich1. 1. Department of Radiology, University Hospital Zurich, Zurich, Switzerland. 2. Department of Radiology, University Hospital Udine, P.le S. Maria della Misericordia Udine, Italy. 3. Department of Traumatology, University Hospital Zurich, Zurich, Switzerland. 4. Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
Abstract
BACKGROUND: To quantitatively and qualitatively assess vastus medialis muscle atrophy in asymptomatic patients with anterior cruciate ligament reconstruction, using the nonoperated leg as control. METHODS: Prospective Institutional Review Board approved study with written informed patient consent. Thirty-three asymptomatic patients (men, 21; women,12) with ACL-reconstruction underwent MR imaging of both legs (axial T1-weighted spin-echo and 3D spoiled dual gradient-echo sequences). Muscle volume and average fat-signal fraction (FSF) of the vastus medialis muscles were measured. Additionally, Goutallier classification was used to classify fatty muscle degeneration. Significant side differences were evaluated using the Wilcoxon test and, between volumes and FSF, using student t-tests with P-value < 0.05 and < 0.025, respectively. RESULTS: The muscle volume was significantly smaller in the operated (mean ± SD, 430.6 ± 119.6 cm(3) ; range, 197.3 to 641.7 cm(3) ) than in the nonoperated leg (479.5 ± 124.8 cm(3) ; 261.4 to 658.9 cm(3) ) (P < 0.001). Corresponding FSF was 6.3 ± 1.5% (3.9 to 9.2%) and 5.8 ± 0.9% (4.0 to 7.4%), respectively, with a nonsignificant (P > 0.025) difference. The relative muscle-volume and FSF differences were -10.1 ± 8.6% (7.1 to -30.1%) and 10.9 ± 29.4% (39.7 to 40.1%). The qualitative assessment revealed no significant differences (P > 0.1). CONCLUSION: A significant muscle volume loss of the vastus medialis muscle does exist in asymptomatic patients with ACL-reconstruction, but without fatty degeneration.
BACKGROUND: To quantitatively and qualitatively assess vastus medialis muscle atrophy in asymptomatic patients with anterior cruciate ligament reconstruction, using the nonoperated leg as control. METHODS: Prospective Institutional Review Board approved study with written informed patient consent. Thirty-three asymptomatic patients (men, 21; women,12) with ACL-reconstruction underwent MR imaging of both legs (axial T1-weighted spin-echo and 3D spoiled dual gradient-echo sequences). Muscle volume and average fat-signal fraction (FSF) of the vastus medialis muscles were measured. Additionally, Goutallier classification was used to classify fatty muscle degeneration. Significant side differences were evaluated using the Wilcoxon test and, between volumes and FSF, using student t-tests with P-value < 0.05 and < 0.025, respectively. RESULTS: The muscle volume was significantly smaller in the operated (mean ± SD, 430.6 ± 119.6 cm(3) ; range, 197.3 to 641.7 cm(3) ) than in the nonoperated leg (479.5 ± 124.8 cm(3) ; 261.4 to 658.9 cm(3) ) (P < 0.001). Corresponding FSF was 6.3 ± 1.5% (3.9 to 9.2%) and 5.8 ± 0.9% (4.0 to 7.4%), respectively, with a nonsignificant (P > 0.025) difference. The relative muscle-volume and FSF differences were -10.1 ± 8.6% (7.1 to -30.1%) and 10.9 ± 29.4% (39.7 to 40.1%). The qualitative assessment revealed no significant differences (P > 0.1). CONCLUSION: A significant muscle volume loss of the vastus medialis muscle does exist in asymptomatic patients with ACL-reconstruction, but without fatty degeneration.
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