Alberto Grassi1, Marco Casali1, Luca Macchiarola2, Gian Andrea Lucidi1, Ilaria Cucurnia1, Giuseppe Filardo3, Nicola Francesco Lopomo4, Stefano Zaffagnini1. 1. Clinica Ortopedica e Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Via C. Pupilli 1, 40136, Bologna, BO, Italy. 2. Clinica Ortopedica e Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Via C. Pupilli 1, 40136, Bologna, BO, Italy. luca.macchiarola@hotmail.it. 3. Centro di Ricerca Applicata e Traslazionale, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, BO, Italy. 4. Dipartimento di Ingegneria Dell' Informazione, Univertità di Brescia, Brescia, BS, Italia.
Abstract
PURPOSE: Comparing the MRI features of the grafts between a group of patients treated with an over-the-top anterior cruciate ligament reconstruction technique that preserves the hamstring attachment and a control group with a classical reconstruction technique. METHODS: Patients were assigned to a standard reconstruction technique or an Over-the-top plus lateral plasty technique. All patients underwent preoperative, 4-months and 18-months MRI; together with a clinical evaluation with KOOS and KT1000 laxity assessment. MRI study involved different parameters: the "Graft" was evaluated with the continuity, Howell Grading system, presence of liquid and signal noise quotient. The "Tibial Tunnel" was evaluated with the signal noise quotient, presence of edema or liquid and tunnel widening. All points assigned to each parameter formed a composite score ranging from 0-10. Tunnel and graft positioning were evaluated. RESULTS: At 18-month 20 MRIs (10 each group) were available, demographics were not significantly different between groups. The non-detached group showed significantly less liquid within the graft at 4-months (p = 0.008) and 18-months (p = 0.028), the tunnel was significantly smaller (p < 0.05) and less enlarged at both follow-ups (p < 0.05), signal noise quotient of the intra-tunnel graft was lower at 18-months (p < 0.05). The total score of the non-detached group saw a significant improvement at 4-months (p = 0.006) that remained stable at 18-months (n.s.). CONCLUSIONS: Hamstring grafts, which tibial insertions were preserved, showed better MRI features at 4-and 18-months follow-up, especially in terms of liquid effusion, tunnel enlargement and signal noise quotient. LEVEL OF EVIDENCE: IV.
RCT Entities:
PURPOSE: Comparing the MRI features of the grafts between a group of patients treated with an over-the-top anterior cruciate ligament reconstruction technique that preserves the hamstring attachment and a control group with a classical reconstruction technique. METHODS:Patients were assigned to a standard reconstruction technique or an Over-the-top plus lateral plasty technique. All patients underwent preoperative, 4-months and 18-months MRI; together with a clinical evaluation with KOOS and KT1000 laxity assessment. MRI study involved different parameters: the "Graft" was evaluated with the continuity, Howell Grading system, presence of liquid and signal noise quotient. The "Tibial Tunnel" was evaluated with the signal noise quotient, presence of edema or liquid and tunnel widening. All points assigned to each parameter formed a composite score ranging from 0-10. Tunnel and graft positioning were evaluated. RESULTS: At 18-month 20 MRIs (10 each group) were available, demographics were not significantly different between groups. The non-detached group showed significantly less liquid within the graft at 4-months (p = 0.008) and 18-months (p = 0.028), the tunnel was significantly smaller (p < 0.05) and less enlarged at both follow-ups (p < 0.05), signal noise quotient of the intra-tunnel graft was lower at 18-months (p < 0.05). The total score of the non-detached group saw a significant improvement at 4-months (p = 0.006) that remained stable at 18-months (n.s.). CONCLUSIONS: Hamstring grafts, which tibial insertions were preserved, showed better MRI features at 4-and 18-months follow-up, especially in terms of liquid effusion, tunnel enlargement and signal noise quotient. LEVEL OF EVIDENCE: IV.
Authors: G Cassiolas; M Berni; G Marchiori; M Bontempi; L Bragonzoni; G Valente; A Grassi; S Zaffagnini; A Visani; N F Lopomo Journal: J Biol Regul Homeost Agents Date: 2018 Nov-Dec Impact factor: 1.711
Authors: Pieter Van Dyck; Katja Zazulia; Céline Smekens; Christiaan H W Heusdens; Thomas Janssens; Jan Sijbers Journal: Orthop J Sports Med Date: 2019-06-03